Hospital or managed care?

[msladynurse4life, BSN, RN]

I am a fairly new CM. I work in a big teaching hospital doing case management for the Trauma/Surgery service. It's very challenging with complicated cases. Most of my patients are either gun shot victims or s/p MVCs and have no insurance. I also do the utilization reviews on these cases, which is another job in itself. I love doing case management, but the hospital setting can be quite overwhelming at times. Once I get more experience as a CM, I thought about branching out to other areas such as working for insurance companies or managed care. I have my BSN and I am ANCC med/Surg certified and have 10 years of Med/Surg & Psych experience in the hospital setting. Any advice?

[msladynurse4life, BSN, RN]

I am a fairly new CM. I work in a big teaching hospital doing case management for the Trauma/Surgery service. It's very challenging with complicated cases. Most of my patients are either gun shot victims or s/p MVCs and have no insurance. I also do the utilization reviews on these cases which is another job in itself. I love doing case management, but the hospital setting can be quite overwhelming at times. Once I get more experience as a CM, I thought about branching out to other areas such as working for insurance companies or managed care. I have my BSN and I am ANCC med/Surg certified and have 10 years of Med/Surg & Psych experience in the hospital setting. Any advice?[/quote']

I guess my question is the hospital setting more stressful with more case loads to manage than working for insurance companies or are they similar? I've always worked in the acute hospital setting, so I don't know too much about other areas. I love doing case management and new to this field and just curious about other options.

[nurseprnRN, BSN, RN]

I found it less stressful, if only because I didn't have to worry about missing things or looking at multiple insurance providers (or lack thereof). This last issue will be going away now that the ACA is getting fully implemented. You'll have a different case load, different reporting requirements, and different hours. I suggest you hook up with the local or regional CMSA chapter and do some networking about how others see their jobs in your area, and go to the national conference for sure. You'll meet people and learn things about every possible kind of CM there is.

CMSA 2014 Conference & Expo - Cleveland, OH - June 17-20, 2014