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Hey DSanto, Without a doubt, I believe that clinical experience such as hospital nursing would definitely prepare you well for a position in case management. However, there are nurses that enter case management without any experience whatsoever. It's not the best way but it can be done. Again, if it's what you want then go for it. I've never been one to travel a path just because others said I should. I create my own paths. Sometimes it works well for me, other times it doesn't but I've certainly learned a lot.

You couldn't be more correct. There were so many clients that I was unable to even attempt to reach. In addition to communicating with them via telephone, I also saw them face to face in our centers and performed a disease specific assessment. Because the organization was for profit, they really pushed the concept of increasing numbers, meaning, it was more important how many clients we contacted vs quality of outcome. However, when clients had a less than favorable outcome, which we often could not avoid as most of them had been on a very slippery slope at the onset of the program, we were slammed for it. It was very unrealistic and quite stressful. :uhoh21: I certainly tried to do my best but with the workload it became increasingly difficult to maintain the quality of work I pride myself on. I eventually left the position for managed care case management. You live and learn...

Hi all, I worked in disease management and my caseloads were much higher. I've had caseloads that fluctuated between 700 - 1000 and even went higher at certain points. Is this a lot? OMG it is most certainly a lot and there was no way that I could possibly touch base with all clients. The company I worked for was just a bit too ambitious. The diseases that I worked with were diabetes, CHF, and depression. If the clients are stratified and classified correctly you can handle higher caseloads but nothing like the amount that i was given. I assume the caseload is also determined by the number of clients your organization has in ratio to the amount of nurses they employ. The nursing shortage results in us having to carry a much higher workload. The frequency that we touch based with the clients was determined by their level of stability. For example, let's say client A is a type II diabetic and has a HgbA1c of 6.5 or lower, her BP has been consistently stable at or below 120/70 and she is compliant with her med regimen and MD appts. This is a client that would be considered low priority and we would probably reach out to her once every 2-3 months. However, let's see client B is a type II diabetic with a HgbA1c of 10.5%, and uncontrolled BP. This is someone that we would probably reach out to a couple of times of week to provide ongoing education, monitor their glucose and BP and ensure that they're taking their meds as prescribed. I found disease management to be exciting. I appreciated the autonomy it allowed me. You really have to be able to think out of the box. Another aspect of I liked was how you were able to realize the results of your actions almost immediately. It gave a wonderful sense of satisfaction to assist a client and prevent them from requiring hospitalization.

Just wanted to add this lil tid bit: Salaries for RN CMs (at least in NY) are pretty durn good. Depending on who employs you, the salary can go up to and over 90k, with the average being in the mid 70s to low 80s. Based on interviews and job offerings that I've received, salaries are increasing. A lot of hospital floor nurses find that they have to work the evening or night shift to push the salary up higher. In most cases, as a CM, you work Mon-Fri from 9a-5p with holidays and weekends off. In addition to working for insurance organizations, there are also opportunities in home care agencies, psych residential facilities and group homes. If this is what you want to do, go for it. Again, be mindful that a clinical background will allow you to be much more successful in this position as well as have more confidence in your capabilities. Best to you!

Hi DSanto, I live in NJ and work in NY as a Nurse Case Manager. I am an RN and used to work in a organization that hires LPNs as Nurse Case Managers. The case management is done telephonically. The nurse does not see her client face to face but depends on assessment completed by visiting nurses to determine what services is necessary. Although some managed care insurance organizations will hire LPNs in this capacity, I don't know of any hospitals that do. I do know that more and more organizations are hiring LPNs because of the financial advantage. The company benefits enormously. The disparity in salary betwn LPN and RN could range from 20K-40K. The LPNs that I have worked with have been extremely competent and have several years experience in a hospital and skilled nursing facility setting. The clinical experience is invaluable. Hopefully this has been of some assistance to you. Are you getting pounded today with snow like we are? We have almost 5 inches. Yayyyyyyyyyyyyyyyyyyyyyyyyyyy!!!!!!