Telephonic Case Manager...Sales?

Specialties Case Management


Hello! I am considering applying for a work at home case manager (telephonic) position. Ive heard from some people that these positions are much like 'sales' positions with quotas to meet, and so on. I'd would like to know from those with experience, is that really the case?? What is your day as a TCM like? One of the companies I'm looking into is Humana and I've heard mixed reviews on them as well. If anyone has any insight on the position or the company, I'd love to hear from you!!

Specializes in OB/Gyn, Post Partum, Antepartum.

Never worked for Humana, but do case management for another insurance company. We do have quotas. I must admit that it does feel like I'm a sales person at times. I've been doing it for 3 years and can tell you I really do not like it. Plan on getting out. Some people I work with don't mind the job. Its personally not my cup of tea.

Specializes in UR, CM, MS, ICU, Stepdown, Informatics.

I am a Telephonic Case Manager for a large insurance company. I do not have any quotas - well I have "Performance Guarantees" but they are not outrageous and I've never felt pressure about them. I really never thought of this as a sales position but I am discussing programs with members to improve their health. I guess the position varies from organization to organization. I provide telephonic CM by contacting members who have been hospitalized. Through telephonic assessement I determne if they need further asisstance to ensure positive outcomes. If the idea of quotas does not sound like something you would like - and it can be very stressful, continue looking. There are many WAH (work at home) telephonic CM positions that do not require "quotas" out there.

FYI, not sure but most places require some period of time in the office before becoming work at home, but not all. I had to work in the office for 3 years before I got to go home. Some only wait a year, others only a few months.

My day is very self-regulated. You need to be able to self manage. I have a list of members to contact and through motivational interviewing techniques, I work on changing behaviors to improve health status. Quality of work is important and there are guideline that must be followed for documentations. This position requires good computer skills and I am in several programs at the same time to gather information and provide resources to members. I work with a team and we have a great group. We collaborate about issues and concerns we have and rely on each others expertise to provide the highest quality service to our members.

This position (at least mine) is HEAVILY monitored. I am continuously recorded and my computer is monitored closely. I recieve monthly audits on both my telephonic skills as well as my documentation skills. It can be extremely stressful. I help people make changes and help then avoid hospital stays and illness. I love what I do and I think it a valuable position.

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