Published Feb 3, 2013
RLDARN
10 Posts
Wondering if I will like case management ??? Any suggestions in weighing out hospital vs CM?
SummerGarden, BSN, MSN, RN
3,376 Posts
I am a Case Manager and I work in two hospitals. Your question does not make any sense. Hospital vs. CM? What are you trying to ask?
Wondering if I will like case management ??? Any suggestions in weighing out hospital vs CM?[/QUO
Sorry. I am weighing CM position with insurance company vs. bedside care.. Afraid of getting bored sitting in a cubical I'm do use to the hustle and bustle of floor nursing but the 12 hr shifts are not good for single parenting.
I work as a UR Nurse and I work a Case Manager in a Combo UR/DC planning role within hospital settings. For some idea of how fast paced a hospital Case Management job can be, where one is a UR/DC planner, please check out my response to the following thread: https://allnurses.com/case-management-nursing/case-manager-bedside-813128.html
As for being a UR nurse only, the job can be stressful and fast paced in the sense that you will need to perform X number of reviews in a shift, get back to insurance companies in a timely manner, and you will need to understand various insurance criteria and medical criteria that justifies medical care like the-back-of-your-hand. In addition, you will also need to speak with patients and health care team providers at times because charts can miss information. The only problems I found in only being a UR Nurse is that people and health care team providers think you only care about your company getting paid, thus they can lash out at you for asking questions or attempting to address concerns. Plus, at times you will need to forward or send an insurance denial letter to a patient, which of course makes their family and the patient angry.
As for a job as a Case Manager for a specific insurance company, another CM will have to answer your question. Personally, I believe the most fast-paced-non-sit-down jobs in Case Management are jobs within the Home Health, Public Health, Hospice, and Hospitals settings, where the Nurse CM collaborates in direct patient care.
Joe NightingMale, MSN, RN
1,523 Posts
I do CM work for an insurance company that handles Medicaid. I'm definitely not bored.
I do a lot of different tasks, from providing members with information on disease and doctors to helping resolve difficulties getting medications or seeing specialists to reaching out to new members and assessing them. It's busy and a fair amount of stress, but I'd never go back to bedside nursing after this....having regular hours and holidays off, not having to constantly answer call lights, not having to worry that a minor mistake might lead to someone's death, having more freedom to do things your own way, not having to hand off patients to other nurses and get grilled, and having opportunities to move in other directions.
KbmRN, ADN
71 Posts
I did case and disease mgmt for an ipa and it was torture being there for 8 hrs a day 5 days a week.. felt like I lost some skills sitting at a cube all day. My .02
Quaffetti
76 Posts
I just started in UR after being a telemetry nurse for 20 years. I never "hated" bedside nursing, but I felt I was becoming a bit jaded in bedside nursing. Plus, as I was getting older (I'm 50) I didn't want to risk a back injury or something like that that would make my elderly years miserable.
Although I have only been in the position a month, so far the things I like about it are that it seems to fit the way my brain works. I am a very methodical, task oriented person (which was kind of a down side as a bedside nurse cause I always wanted to get all my "tasks" done and not sit and comfort the patients). So in UR, my very logical, right brained type thinking fits in perfectly. There are ordered steps we follow, tasks to be done, etc. Not that clinical judgement doesn't come into it; I am not explaining myself very well; it just seems orderly to me and works well with my personality.
The downside to UR nursing is it's a very sedentary position. I sit in front of a computer all day. Although I will say that since the job is not as stressful as floor nursing, and there isn't the time crunch that exists in floor nursing, I can get up and walk around for a few minutes every hour. But still, it's VERY sedentary. That's really the only thing I've found that I don't like about it.
And although there is a lot of work to be done, I don't feel the stress I did as a bedside nurse, cause I don't have to worry about making a mistake that leads to killing someone or getting my ass sued. In this position, if I make a mistake, I will be corrected and that's it. It's a learning experience. Perfection is not required in order to avoid being sued.
I think to make your decision you just need to think about what type of person you are and if the position suits your personality. If you like action, activity and lots going on at once, you probably wouldn't like CM nursing.