Metrics Driven Case Management

[Bella RN, BSN, MSN]

Hello,

I have not been on this site in so long. I have been working for a large insurance company telephonically and remotely. Pays well, good benefits.

 

I do not like that is very metric driven role. We must enroll 32 members a month. It makes me feel like a herdsmen trying to get cattle. There is really no opportunity for growth here. I voiced my desire to grow and have applied to countless positions but never got the transfer or the promotion.  Only twice in the 7 plus years that I have been here has there been opportunities for advancement. 

On my interviews I often impress them. They tell me I am amazing during interviews and my credentials are impeccable, but I do not get the promotion or job.

I am beginning to resent the metric set up. Sometimes people do not answer the phone. I have been away from bedside Nursing since 2010. I have no desire to go back. I do like managed care and have a high interest in policy and procedure or risk management. Not sure how to get into that.

 

I am a couple of classes away from obtaining my MSN with a specialization in Public Health. I feel we have been put in a position to grasp at straws just to get a member enrolled in the program.

 

Many Nurses have told me I should be a manager or in a leadership role, but I have no leadership experience and not sure what to do. I am one of the very strong seasoned Nurses on the team.

 

Any thoughts or advice?

Thank you

[TAKOO01, BSN]

It sounds like you are feeling stagnant in your current role, yet your job has no management opportunities available. You have a few options:

You can apply for management positions at other insurance companies.

You can look for other opportunities to expand your knowledge and boost your visibility in your current organization. For example, if there is a problem area that you see that co workers struggle with, you can present some solutions to management. 

You can wait until another management position opens at your company and apply.

Im not sure how the Public Health MSN will tie in to case management. At my case management job, the managers had a variety of master's degrees. I don't think the type of master's really mattered. At your job it may be different and you can use the masters to maneuver into a new position. 

Talk to a manager with whom you have a good rapport to see if they have advice on how to move ahead in the organization.

[Bella RN, BSN, MSN]

Thank you so much for this wisdom. I want to brush up on my computer skills. I am almost done with school. I do not want to stay in a metric driven role, but I will learn and grow while here.

 

Thank you again ?

[Neats, BSN]

Ugh.... as a case manager I have never had to "enroll" new customers. I would have left a long time ago.  

To answer your thoughts about public health and getting into the administration side of nursing.....

I would look for state opportunities, federal opportunities. If you are in school I would look for fellowships that you can get into as a senior or new grad. Go to your local VA visit their web site. 

[RN1485, BSN]

This is interesting because I am on the flip side working as a public health nurse case manager (they actually tie in nicely with each other) wanting to get a job as a case manager for an insurance company. I actually have a second interview for a telephonic case manager on Friday. I’m having second thoughts though because of the metrics and micromanagement that you posted about. Public Health can be very rewarding and I really do love my job. I’m rarely micromanaged and we are responsible for maintaining our training so we are up to date with everything. We have audits but it has never been stressful. However, pay is abysmal!! And I feel the same as you that there aren’t many growth opportunities. In my state there is no pay raise, no tuition reimbursement, and rarely any promotional or lateral opportunities. You could probably start higher on the totem pole since you have an MSN in public health with several years experience. I do feel like I’m actually helping people and it’s not so focused on the bottom dollar. The work life balance is nice with government holidays, etc. Feel free to message me if you want if you have any public health questions.