rncm2010

To the OP, All you can do is follow orders, do thorough documentation ,and act in the best interest of the patient. If you do that, you are golden. Much worse to let your practice be stifled by a grumpy colleague. It has nothing to do with you. You know by now that you will encounter plenty of A-holes along the way - everyone does in every job! Just concern yourself with your own integrity. A lot of this knowledge comes with life experience, and certainly nursing experience.

It isn't true of ALL telephonic positions, even though it makes sense for it to be. For example, the company I work for currently has UR positions that work from home and they are NOT micromanaged at all. They have loose quotas but they are very understanding that some cases take longer than others. My opinion is that if you work for a larger company, especially a national one, you will see more micromanaging and metrics than if you work for a smaller company like I do. We have around 1500 employees and serve only one state.

I love CM working for an insurance company from home. Totally independent but have my team for support if needed. It depends on the company you work for. The larger companies seem to micromanage staff, but if you get in with a smaller company (My company has like 1500 employees) then you won't get micromanaged as much. The pay may be lower though, too.

I work from home as a CM for an insurance company in the Pacific NW. My days are 10 hours long, 4 days per week. I have the option of working 7 am till 5pm or 8 am till 6pm. I usually start by reading 100 emails that came in overnight from the other departments. Most of them I can delete and don't pertain to me. I get cc'd on tons of irrelevant stuff. I listen to voicemails. Then I follow up on my current client list. I have 28 clients now and am trying to build up this list. It is all over the phone. I make calls to clients to follow up. I ask how they are doing. I find out if they have new needs I can help with. Sometimes I listen to them vent about their situation. I also review and authorize or deny anything that comes in for them (i.e. pre auth requests). I am always having to verify eligibility first. We create care plans and update them as the member meets goals. The thing I do the most is call people, talk to them and document our conversations. It is a great job, tedious at times to do so much documentation. The part I like the least is all the requests I get from other departments like negotiating rates, etc. It is not my job to do this but sometimes it takes many emails to get everyone on the same page. Also, I work in 5 different programs using two computer screens. There is a lot of logging in and out of programs and searching for emails.

I know someone that works there that I used to work with at a different insurance company. She tells me she is micromanaged and her calls are timed, etc. She is questioned if she doesn't meet productivity numbers. On the plus side she got a raise when she went there from her prior company and she was allowed to go work from home almost immediately.

I'm an RN, BSN working as a CM in an insurance company. I had 4 years of SNF direct/bedside care when I started in Utilization review for an insurance company. One year later I advanced into CM for the same company. I got an 8 % raise along with the move. So now I am making 70k annually. Our benefits are great: 10 paid holidays, 12 PTO days first year, 15 PTO days second year, etc. Medical/vision/dental covers my whole family (2 adults and up to 4 kids) for $300 out of pocket in premiums per month. We have 401k with matching, flexible spending accounts. I work 4 days per week (10 hr days) and I WORK FROM HOME! Our home office equipment is provided by the company. If I chose to work in the office the location is downtown, gorgeous location and building, but parking costs $200/month. There is a commuter subsidy for people that use public transit. Could it get any better? I wish I was paid more but it isn't bad.

I came into my role as CM for an insurance company with NO CM experience. I had only had bedside direct care experience in a SNF setting for 4 years, plus 1 year in utilization review. I was started at 69k annually plus a great benefits package, 9 paid holidays, 13 days PTO the first year. I noticed that our local hospital pays a higher range ($36 to $52/hour) for case managers. I am in Oregon.