RN looking to do Case Management

[VerbalGrl715]

I am an RN-BSN interested in Case Management. I have been an RN for 6 years and have experience in Telemetry, Long Term Acute and Critical Care. I hear a lot about Humana, in fact I applied there for a case management position yesterday, but are there other insurance companies that hire RN's to do this? I live in FL in the Tampa Bay area so any advice is helpful.

[mtngrl, ASN, RN]

I work at BlueCross BlueShield and have also worked for United Healthcare. Check their websites they always have some sort of position for RN's and a lot of times it's working from home.

[shaynurse53]

what all do you do in a case management position?

[nurseprnRN, BSN, RN]

The minimalist definition of case management is that it influences the course, duration, and cost of medical care by facilitating and coordinating care.

My best suggestion is to check out the CMSA website and the CCM certification board for a lot of information.

[shaynurse53]

ok thanks, i graduate in two months and i am interested

[mclennan, BSN, RN]

ok thanks i graduate in two months and i am interested[/quote']

I have never heard of any new grad going into case management. It requires years of experience.

[nurseprnRN, BSN, RN]

New grads will not get CM jobs, period. To be a CM you need years of good experience in, optimally, multiple care settings, with experience in coordinating care for many different illnesses and injuries, evaluating situations and families, working with physicians and nursing in many specialties, and at least a minimum working knowledge of community resources and the vagaries of health insurance. New grads will not have this. Every CM I have ever known had at least 6-10 years of nursing experience before getting a CM job. Almost all the ones I work with now have been in nursing for at least 20 years.

[Saifudin]

I'm curious how do you break into the field. I've been in healthcare for 35 years. I'm an adult NP, worked as a DON in addiction/mental health and most recently, lead a QI and Pt. Safety department in a community hospital. Last two positions were overseas in the Gulf. Positions advertised usually ask for experience. Will certification potentially open the door?

[nurseprnRN, BSN, RN]

Yes, but you need to have experience in the field to sit for the certification examinations. (As with most certifications, they validate expertise, and you can't have expertise without experience, by definition.)

[LabellaRN]

I disagree with most of you a new RN with no experience can infact be a CM all depends on knowledge and individual abilities!! Now I got offered a CM job paying 70k a year but again maybe because I am bilingual but all the same this proves that rules do have exceptions !The interview was though and I was going against experienced RNs , I had to go for 3 different rounds of interviews but I got the job . Everything is possible.

[chadrn65]

I disagree with most of you a new RN with no experience can infact be a CM all depends on knowledge and individual abilities!! Now I got offered a CM job paying 70k a year but again maybe because I am bilingual but all the same this proves that rules do have exceptions !The interview was though and I was going against experienced RNs , I had to go for 3 different rounds of interviews but I got the job . Everything is possible.

Did you get hired with UHG, Conifer Health Solutions or possibly Cigna? For I know for a fact that all three of these companies have hired nurses with 1-3 years of recent clinical experience for RN telephonic chronic disease case management positions (remote) and very helpful if you are bilingual! Plus these companies want you take your CCM exam within 2 years after starting....which explains how these companies get away with not hiring experienced case managers and/or already certified.

My co-workers and I were recently laid off and we are finding out that many of these companies are difficult to get your foot in the door. Collectively, we all have many, many years of medical case management, some of us also have experience in workers comp, but maybe because we are older??

[chadrn65]

I'm curious how do you break into the field. I've been in healthcare for 35 years. I'm an adult NP, worked as a DON in addiction/mental health and most recently, lead a QI and Pt. Safety department in a community hospital. Last two positions were overseas in the Gulf. Positions advertised usually ask for experience. Will certification potentially open the door?

Look at UHG, I see NP positions advertised with your type of experience.