insurance companies?

Specialties Case Management

Published

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I have been an RN for 7 years. Worked sub-acute unit, charge nurse on tele/oncology at hosptial and now am at the health department. I was wondering if I look in the Insurance companies for CM work am I qualified without taking more education? Do most places want you to have CCM? Will they do much training? Is that the best place to start out? I just really need a career change!!!! I love being a nurse but getting to hate my job.

Sounds like you have home health experience with CM. You will be fine. You will develop more telephonic skills. I sit in a cube all day and talk to my coworkers who sit near me. We work and have fun at work also.

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I have been doing work comp case management for 2 years. I prviously had 8 years of home health experience. I have recently changed company's. I have my CCM.

WC case management is normally not a fun job. It does beat working as a floor nurse in hospital or nursing home. You will find that your time is tied up with typing reports, making phone calls to injured workers, employers, adjusters, MD's, PT's, vendors, and traveling.

The hard thing about case mangement is that you usually aren't paid just for working 8-5. You will have to put a time on everything you do to make your 40 hours or more per week. For example: typing a letter would be a .3 and phone calls are also timed. If you are on the phone for 10 minutes it would be a .2, and typing a report is usually a .8 up to 1.5. You will be billing for travel time, mileage, and wait time if you go to an appointment with an injured worker; this is if you do field case mangement. And let's not forget about those injured workers that think you are the person that has stopped their TTD payments or that you are trying to make them go back to work.

Like I said it's not as great of a job as it appears. There is something to be said for just going to work and putting your 8 hours in and coming home. If you work from home, you never really leave work, and most people act like you aren't working if you work from home. They will ask you to babysit and run errands. I am not saying that it is a bad job, but it is not as easy as it seems. It is a very time consuming job.

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I work in an insurance company and there are nurses who have worked in WC that like our job much better!

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good evening wincha....i myself am also interested in working cm for an ins co....but dont have much experience in cm...may i ask what ins co would be good to apply to or who you work for? Any advice or input would be helpful..

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wc case management is normally not a fun job. it does beat working as a floor nurse in hospital or nursing home. you will find that your time is tied up with typing reports, making phone calls to injured workers, employers, adjusters, md's, pt's, vendors, and traveling. i do medical case mgt and yeah it beats doing direct care & lifting pt's, my body can't take that anymore. you are correct about the phone calls, typing reports, visiting clients, etc..lots of phone work in case mgt & documentation with each call as you stated below.

the hard thing about case mangement is that you usually aren't paid just for working 8-5. yep! often working late in the evening at times. you will have to put a time on everything you do to make your 40 hours or more per week. for example: typing a letter would be a .3 and phone calls are also timed. if you are on the phone for 10 minutes it would be a .2, and typing a report is usually a .8 up to 1.5. you will be billing for travel time, mileage, and wait time if you go to an appointment with an injured worker; this is if you do field case mangement. almost same billing system we have. and let's not forget about those injured workers that think you are the person that has stopped their ttd payments or that you are trying to make them go back to work. i don't do wc, but i can see this happening.

like i said it's not as great of a job as it appears. there is something to be said for just going to work and putting your 8 hours in and coming home. if you work from home, you never really leave work, and most people act like you aren't working if you work from home. they will ask you to babysit and run errands. i am not saying that it is a bad job, but it is not as easy as it seems. it is a very time consuming job.

often your clients think you are available 24/7, and it is not like that. i do not tell them that i work from home. yes, there are people that think just because you work from home, they can just stop by while you are on the phone discussing a client with a physician..and they are knocking on your door, without thinking that we are at work too! also, hubby seems to think i am available for errands etc.. grrrrrrr!
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Specializes in Med/Surg, Oncology, ER.

Lizzy6------Just wondering if you could give me any ideas of how to find a work from home case management position, or what companies to look at......Thanks

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Lizzy6------Just wondering if you could give me any ideas of how to find a work from home case management position, or what companies to look at......Thanks

I would look in your city Sunday newspaper. Also, do you receive the nursing Spectrum and Advance magazines (they are free), I see a few ads posted with every new issue advertising for case managers. Some of these positions are either work at home/some are not. Also, do a search for Concentra, Intracorp, Genex as others have posted etc...Submit a resume, they could have contracts in your area. Worth a shot. Hope that helps.

Lizzie

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Specializes in Med/Surg, Oncology, ER.

Thank you......

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Specializes in Home Care.

Intellicare is also a company where employees are remote....work from home. They offer triage nursing and/or disease management. Great company to work for. They have openings coming up. Go to their website.

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Specializes in NPD; Administration; M/S; Critical Care.
I would look in your city Sunday newspaper. Also, do you receive the nursing Spectrum and Advance magazines (they are free), I see a few ads posted with every new issue advertising for case managers. Some of these positions are either work at home/some are not. Also, do a search for Concentra, Intracorp, Genex as others have posted etc...Submit a resume, they could have contracts in your area. Worth a shot. Hope that helps.

Lizzie

Yes, thanks so much for this information! There are many postings about how great case management is, but knowing where to begin is paramount!

:lol2:

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good evening wincha....i myself am also interested in working cm for an ins co....but dont have much experience in cm...may i ask what ins co would be good to apply to or who you work for? Any advice or input would be helpful..

can you private message me that question? i can't figure out how to pm you.

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:roll

I have been an RN for 7 years. Worked sub-acute unit, charge nurse on tele/oncology at hosptial and now am at the health department. I was wondering if I look in the Insurance companies for CM work am I qualified without taking more education? Do most places want you to have CCM? Will they do much training? Is that the best place to start out? I just really need a career change!!!! I love being a nurse but getting to hate my job.

I did it the other way around. I was a CM and UR coordinator for over 20 years, but NOT a nurse! I have a CCM and CDMS. Since then, I've got my LVN and am going for an RN.

Bankers hours, national holidays, stock options. Most of it is just, plain common sense.

Negatives-- Working during a merger or hostile takeover is hell!

However, your job satisfaction depends on the specific insurance company you work for. The range is very braod- re: management skill v. idiocy.

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