Which job should I take?

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Specializes in Critical Care, Insurance Case Management.

Here's an odd dilemma to have: I have 2 potential jobs, and I need some opinions about pro and con, and which way to go. First, some background:

I am 50, 22 years experience with critical care, case management (insurance), and home care/mental health. Recently divorced, need a full time job to work on retirement savings, but also have hobbies that pay well, and 2 kids still at home. I have an RN, and a masters in health administration, been working part time in the home care/mental health, looking for full time CM. I have been running a sole proprietorship as a custom drapery fabricator and upholsterer for 7 years, and am very good at it, can't completely give it up as it is a stress outlet and design satisfaction.

The 2 jobs I am considering:

Both are in the same health system, job one is for an insurance managed care insurance doing Medicare Care Management for senior, all telephone work, M-F 8 to 4:30, no weekends or holidays, can work at home after 6-9 months. Education, challenging, friend works there and likes it, good benefits, could be boring.

job #2: Hospital CM, float between 2 hospitals in a large CM dept, not sitting, busier, M-F 8 to 4:30 with some weekend and holiday rotation. Very busy, not sitting on my rear at a telephone all day, but could mean 10 hour days and weekends/holidays.

I hope to save enough to retire in about 14 years, so I can go back to sewing full time, so whatever I pick, I am stuck with. I still have to be a single mom, like to sew, have to have a life, but hate being bored. HELP!:eek:

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I 1st want to applaud you for being amazing:clphnds:. Being a mom is hard in itself let alone a single mom with your accomplishments. 50 is the new 25 =) It's always a great idea to save for retierment. And retire is when your tired, when you want to sit on your butt. Weekends- Holidays- CM are hard with kids ,... but great for your wallet if retirement is what your striving for.Right now it sounded like you answed your own question of bordem.:anbd:. Good luck in your decision I know kids are #1 always. I'll pray for you.

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Specializes in Occupational Health Nurse/ case manager.

Hi,

I have a sister-RN who does telephonic case management and she states that the caseloads can be very heavy, depending on where you work and that there is a big turnover in this type of case management. She also states that she hates being on the phone all day without seeing the client. She is bored with the job and misses the "hands-on" aspect. But.....this is her opinion!

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Specializes in Critical Care, Insurance Case Management.

That's what I am afraid of - I should know better than to take the easy way out with cushier working conditions, because I worked at Blue Cross and became very bored in 2 years. but the weekends, holidays - :o Oh well, hopefully there is overtime!

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Specializes in Assessment coordinator.

Be careful taking a case management job with a Medicare replacement provider. Do some research on what is in the works for healthcare reform. Luckily you have back-up, but be careful to see the handwriting on the wall, as well. Some Medicare Advantage providers are seeing some heat from the Feds and that is not well known.

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Specializes in Critical Care, Insurance Case Management.

Well, I'm on to phase 2 for the hospital job - background check and telephone interview next week. Just hope they don't low ball me on an offer, because I need the job. I made $55,000 with a company car in 1992! The pay range on this job is $49,000 to $71,000, and with 23 years as a nurse, 7 as a CM, and a masters, I expect a decent offer in the middle. Problem is current pay for what I do now isn't that high, but met my needs at the time. In this tough market, I am afraid to negotiate.

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Specializes in Critical Care, Insurance Case Management.

Just an update, in case anyone is curious :loveya:

I accepted the hospital CM position and start Jan 4 - looking forward to the change, although a bit concerned about how I get up in the morning to get to work that early :D I feel fortunate to get this, given the MI economy; next step is to get a kid graduated, then try to sell and downsize to move closer to the new job.

Merry Christmas, and Blessed New Year:jester:

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Specializes in Obstetrics/Case Management/MIS/Quality.

best of luck to you in your new position! what a way to start the new year!! i hope you enjoy your new position as much as i enjoy mine. i just started 2 months ago as a hospital cm...i think it's great so far!

:snowman:

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Specializes in Occupational Health Nurse/ case manager.
Just an update, in case anyone is curious :loveya:

I accepted the hospital CM position and start Jan 4 - looking forward to the change, although a bit concerned about how I get up in the morning to get to work that early :D I feel fortunate to get this, given the MI economy; next step is to get a kid graduated, then try to sell and downsize to move closer to the new job.

Merry Christmas, and Blessed New Year:jester:

Adlock,

How is the hospital case management position going? What have you learned and is the position what you expected?

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Specializes in Critical Care, Insurance Case Management.

I must say that external case managers are more involved in "real" case management. Inpatient CM is not very satisfying in that you spend 2 hours just figuring out who is on your patient lists and where they are in the process, plus the nurses do their own reviews. It is usually almost noon before I hit the floor to see patients, and out of a case load of 16-20 daily, I see 5 max. A lot of discharge tasks. And most leave at 4:30, because on salary, you don't get paid to put in 10 hour days (although some days it can't be helped) If I had my way, the utilization review would be handled by the dedicated UM staff = after all, they are nurses too. In our hospital, the social workers have their reviews done by the UM staff. I guess the theory is, nurses know their patients - but in reality if you check the charts to look at the criteria for UM, it is a waste of effort and time to go back to your computer and do the review, then see the patients (back up on the floors) By the time you meet the patient, and do the computer work both in the EMR and our Allscripts web based referral/review program, you may spent 45-60 minutes on a patient. That means you see 4-6! And we are reminded we have rules that state you must do your initial assessment in 24-48 hours of admission. When you get 6 new patients a day to your roster, that is impossible. Like trying to pay off a credit card while still using it. There are some days 1 or 2 take all day. And don't forget the constant pages. Way too much time sitting in front of a computer - thank goodness I didn't take the telephonic CM job :)

On the good side, the day flys by. On the less than satisfactory side, there is no time to teach, which I like doing. My latest thought is to try working on being a certified diabetic educator, so I can at least work with one group of patients and teach. Our staff gets alerted on EVERY diabetic, and yet all we have time to do it hand them the phone number to the DSME classes.

The drawback to insurance CM is some of those folks are so entrenched with their disability, you can't move them forward and spend months trying. There are pitfalls to all of these jobs. I felt lucky just to be working days, but the weekend rotations are on the horizon, and they just put us on holiday rotation too, without the hourly bonuses that floor nurses get for working holidays because we are on salary. I guess I stepped in to this job at a point of major management changes, and they are going back to the way things were 20 years ago when schedules were dictated, not self coordinated. I am just trying to avoid the negativity, do the job, and watch for the next opportunity!

Thanks for asking.....

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