How to become a case manager

SummerGarden, BSN, MSN, RN · Nov 22, 2012

Talk to the hiring manager at the hospital where you work or a former nursing employer. Ask that person if there are openings, let him/her know of your interest, and ask how you would be considered for an entry level position. That is the best way to get into Case Management. Good luck.

missladyrn · Nov 22, 2012

Oh, the land of 9-5, how I would love to be part of theeeeeee! At my hospital the CM positions are extremely difficult to obtain but I keep putting in and hoping. I am actually in my first trimester now and have been sick as a dog. I am also really tired the 12 hour shifts are literally killing me. I am hoping the sickness passes soon, otherwise I am not going to make it 9 months on my current floor. I asked not to be scheduled 3 days in a row, but every schedule comes out and I am 3 in a row and have to beg people to swap.

mtngrl, ASN, RN · Nov 24, 2012

You can always look at insurance companies, most have case managers that work from home. Where I work if someone doesn't have CM experience they at least like them to have home health experience (because we visit our members in their homes). If you are applying for telephonic case management then that might be even easier to get into.

mclennan, BSN, RN · Nov 24, 2012

I am a case manager RN. I also have a good relationship with my hiring manager and know why she hired me so here ya go:

1. BSN. Most medical groups, insurance co.s, hospitals get better reimbursement and accreditation if CMs have BSN.

2. Some experience in Public Health, health teaching, discharge planning, chronic condition management or something along those lines. Lots of states offer PHN licensure to BSNs whose program curriculum included community/public health that meets requirements. If you can get it, get it. My hiring manager, and 3 or 4 other CMs in my department were PHNs for some years before becoming CMs - she says that pretty much nailed why they hired me. Highlight any nursing experience in which you developed therapeutic, long term relationships with patients and followed them through chronic illness. Any telephone triage expertise or training is valuable too.

3. Get certified as a CM either by the Commission for Case Manager Certification or the ANCC Case Manager Board Certification. I cannot emphasize this enough.

4. Be prepared to sit in a cubicle all day calling patients, to wear business clothes, to earn salary instead of hourly, and go to lots of meetings. It is a far cry from working the floor, the clinic, or 12 hours in scrubs. And it's not always better, it can be just as crazy busy, complicated, stressful and the grind of 9-5, M-F isn't the paradise you might think. We have had a couple of CMs who came straight from inpatient, bedside shift work nursing leave after 5 or 6 months because they missed working with patients and having those 3 or 4 days off a week. And, they missed overtime pay.

5. On the upside, it's very autonomous, independent work that actually uses nursing theory heavily, and really sharpens your critical thinking skills. Docs love us. Patients love that they don't have to come to as many appointments and have a go-to advocate. Case management is gonna be a big thing, it saves everyone money and increases patient satisfaction scores big time. And, the pay is great IF you have the experience and certification!

Hope that helps and good luck!

babynurse73 · Nov 24, 2012

wow! it seems you need a lot of education and experience to become a case manager! I know a couple of ADN's that have become CM's and I was offered a job in CM/Home Health (which I decided not to accept). Is this a good way to gain the experience to get a hospital position without the BSN? I would love to get my BSN, but it is so costly and time consuming (I have taken a couple of on line classes toward it), and I just don't want to do it anymore! Currently, I am L&D nurse and looking to get into CM...

brianrey · Nov 26, 2012

You must know case management before trying to be case manager.Cm is really a great profile to work on.

friendlylark · Nov 29, 2012

Hello! I am considering moving into a Case Management position (I am moving to a new city and seeking a new job). I am a new RN, about 6 months of experience.

(1) Is Utilization Review (UR) the same/similar to Case Management???

I am currently working on my BSN program as well (I have had my ADN since June).

(2) Is home health/case management a good place to start to get into hospital case management?

There is a UR job at the VA in the city I am moving to that I would like to apply. I am trying to consider my 5 year plan and determine if this is a good step for me! I am currently a nurse in the ER and, as a new nurse, not entirely sure if I want to continue the 12-hour shifts of floor nursing or make a shift to the 9 to 5. I would LOVE to have weekends, holidays!!! I really enjoy the ER, but would love to have more flexibility in what I do! I used to work in marketing (non-health-care) and I really miss the office hours. I struggle a bit in the ER with CONSTANT distractions and not feeling like I am in touch at ALL with my patients needs! I believe I would REALLY enjoy following a patient through from beginning to end.

(3) Is Case Management a good career field - lots of room for growth???

Thank you for any replies!

SummerGarden, BSN, MSN, RN · Dec 2, 2012

Hello! I am considering moving into a Case Management position (I am moving to a new city and seeking a new job). I am a new RN, about 6 months of experience.
(1) Is Utilization Review (UR) the same/similar to Case Management???

Utilization Review and Management (URM) is Case Management. Some nurses perform UR only or Discharge Planning/Chronic Management only, while others perform both.

(2) Is home health/case management a good place to start to get into hospital case management?
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Where you start and if it is a good fit depend on your personality and your opportunities. As for getting into the hospital setting, this will depend on employers. Most hiring managers in hospital settings prefer CMs with acute care backgrounds of 2-5 years by the bedside, a BSN, and at least 1 year of CM work experience in the hospital setting. However, it is not unheard of that Nurses with clinical backgrounds of several years outside of the hospital setting along with CM work experience of several years in other areas (HH, insurance, Workman's Comp, etc.) are recruited into the hospital setting as Nurse Case Managers.
There is a UR job at the VA in the city I am moving to that I would like to apply. I am trying to consider my 5 year plan and determine if this is a good step for me! I am currently a nurse in the ER and, as a new nurse, not entirely sure if I want to continue the 12-hour shifts of floor nursing or make a shift to the 9 to 5. I would LOVE to have weekends, holidays!!! I really enjoy the ER, but would love to have more flexibility in what I do! I used to work in marketing (non-health-care) and I really miss the office hours. I struggle a bit in the ER with CONSTANT distractions and not feeling like I am in touch at ALL with my patients needs! I believe I would REALLY enjoy following a patient through from beginning to end.
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Case Management is not stress free fun job for the most part. Also, CM jobs in the hospital setting are not always 9-5-M-F -no-weekends-or-Holidays jobs. In fact, my employers have NOC and PM shifts and we are required to work weekends and Holidays just like any other Nurse. Hospitals admit and discharge patients 24 hours a day 7 days a week.
(3) Is Case Management a good career field - lots of room for growth???
Yes, lots of room for career growth. Most of the growth, however, will be laterally as oppose to upward. The reason being, as with any field there are not a lot of places where one can get promoted due to cut backs. On the other hand, you can move around to different settings, to different positions, and to different facilities with experience, education, and certifications. Good luck.

paradiseboundRN · Dec 4, 2012

I was hired as a telephonic case manager (for a large medical insurance company) after 2 years of med-surg and 6 years of home health care. I do know a lot of home care nurses that have transitioned to case manager (with insurance companies) without a BSN. Home health and case management have their similarities in that both are teaching the patient to manage their diseases and helping them with community resources, transportation to medical appointments, etc. Personally, I found telephonic case management to be extremely boring and left after a year.

Joe NightingMale, MSN, RN · Dec 9, 2012

I'm doing telephonic CM right now. I have three years of med-surg and an MSN.

But I think that's unusual. Most of my co-workers have experience in CM, or UM/UR, or mental health. But my company is kind of a mess, lots of turnover, so that's why I think I got hired with such a lack of experience.

And I'd echo what some of the others have said, many times RNs leave after they find they miss face to face interactions and 3 12 hour shifts. So I'd think about how I'd like a business environment.

Even for someone like myself, who likes this sort of field, I find that CM is probably not the best fit. I'd probably do better with less patient interaction and more clinical data, such as UM/UR or quality or provider services. But the good thing about this field is that there are many different positions available.

jenn1970 · Dec 10, 2012

I was hired as a hospital based case manager at a large teaching hospital in the midwest. I am a diploma grad with 20 years of nursing experience at the bedside. I am not certified but need to be within 2 years. So sometimes experience can override the BSN requirement.