Do you like being a CM in the hospital?

CCL"Babe", BSN, RN · Nov 5, 2008

I have done both UR, DCP & Case Management for an insurance company & now I am Case Manager for a hospital. Hospital CM is more of the UR & DCP in my hospital. The Social Work Department performs the traditional CM role. Positives for me are: better pay, more vacation and better benefits, closer to home. Downside I am working weekends again, but thankfully no holidays. The duties are about the same for the UR & DCP portion. At least you have the charts and can get the info needed to complete the reviews. The politics are more prominant in the hospital setting. I am happier in the hospital setting.

MaritesaRN · Nov 6, 2008

I am a CM for an insurance company currently. This is my first CM position. I am not too happy there for a few reasons, and I've been thinking of a CM position in a hospital.
Is it better to be a CM in a hospital? Do you CM's like it? Has anyone worked both (insurance co and hospital) and which do you like better?
Any advice, comments, etc. appreciated. Thank you. :heartbeat

:bugeyes: I have worked both....but they are really different . The insurance company may be flaky to work with if their sources is vague , or medical director may be difficult to work with. the hospital scene may be chaotic, especially if a system is not in place. You need ownership in a unit so you get to know the people there and work as one, including the physician..otherwise it can be unnerving . but this is just me...you need to see where your comfort zone is. :nurse: Maritessa

delta1961 · Nov 9, 2008

I currently work as cm, am looking for another job-on call every third week 24/7 plus work that weekend-do have a day off before/after working that weekend but am so behind not really much of a benefit to be off those days-work all holidays-MANY social service issues as we do not have social service dept. One night had 4 emergency psych placments (2 had to be EDO), other 2 had no insurance, we had psych beds at our facility-but no psychiatrsist on call that weekend.It was a nightmare-I was in the ED until 4 am and than had to work 12 hour day.I guess you could say I'm a little burned out.Work on average 50-60 hours a week- I think the floor nurses make more than we do in our dept.

Tangerine Lipgloss · Nov 9, 2008

Thank you for your honest answers. I had two interviews, so we will see. I feel more comfortable at the hospital, I don't really like the corporate world. This CM position has a SW and SW asst. working together. The pay/benefits are much better and it is closer to home.

I hope I get it, even though I know it will be very busy. Cubicle world is not for me.

MaritesaRN · Nov 10, 2008

I currently work as cm, am looking for another job-on call every third week 24/7 plus work that weekend-do have a day off before/after working that weekend but am so behind not really much of a benefit to be off those days-work all holidays-MANY social service issues as we do not have social service dept. One night had 4 emergency psych placments (2 had to be EDO), other 2 had no insurance, we had psych beds at our facility-but no psychiatrsist on call that weekend.It was a nightmare-I was in the ED until 4 am and than had to work 12 hour day.I guess you could say I'm a little burned out.Work on average 50-60 hours a week- I think the floor nurses make more than we do in our dept.

Thank you for sharing your experiences..... it helped justified that it was not just me when I decided to quit that CM job in the hospital.The pay was very good , but when I got my first check my federal and state taxes doubled!...so the take home pay was not as much as I anticipated, even though I am the head of household , they still took a lot...it made me wonder if it is even worth putting up w/ the craziness and the disorganization in the facility. You do need social workers for placement issues, and this needs to be recognized even from the ED , so you can assign this part right away to the soc. worker. Like what I said before , if the hospital is big enough , one should be assigned only to one familiar unit , so you and the staff in that unit can function as one. I wish you a lot of luck and guidance.

Maybe you will need to think if this is where you want to stay or not? The floor nurses makes the overtime , but not the case managers since they are considered as admin.sometimes is takes as a couple of positions before we realized what and where do we want to be? blessings to you!:heartbeat

MaritesaRN · Nov 10, 2008

Thank you for your honest answers. I had two interviews, so we will see. I feel more comfortable at the hospital, I don't really like the corporate world. This CM position has a SW and SW asst. working together. The pay/benefits are much better and it is closer to home.
I hope I get it, even though I know it will be very busy. Cubicle world is not for me.

How many beds does your facility have? This will tell you if the one social worker and one assitant is enough. Also , what kind of population do you have? Here in Los Angeles we have a lot of displaced and homeless people , so social work is very busy. In this hospital you are going to work, are the admission people knowledgeable about insurance? Could they identify correctly right from admission as to the difference of medicaid and medicare? These two needs a lot of placement issues.....the answers might give you an idea as to what kind of workload you are going to have.

Best of luck and wish you the best outcome for you in the interview. do not forget that the interview is truly a two way traffic, ask questions , listen and do not be afraid to ask questions over and over.....you are also interviewing them to see if they are good "candidates" for a potential employer. :smokin: