How to Become a Nurse Case Manager

Many healthcare professionals play a role in ensuring that patients admitted to a hospital or healthcare facility receive the best care possible. Healthcare facilities need to assess new patients’ physical wellness, update returning patients’ records, inform patients and their families about healthcare plans, and document routine patient care. These tasks are often performed by registered nurse case managers — trusted and capable professionals crucial to a health organization’s operations.

While nurse case managers primarily have a background in nursing, they may also have additional experience working as health administrators or social workers. Because they make medical and administrative decisions to improve the overall quality of their healthcare facilities, nurse case managers serve as leaders in their field. The process of becoming a nurse case manager and taking on a leadership role requires higher education and a strong background of professional experience.

What Is a Nurse Case Manager?

Nurse case managers collaborate with professionals in the medical field and beyond to provide full care for patients. While they work with physicians in healthcare facilities to provide direct care for individual patients, they also collaborate with social workers, helping members of different populations and communities. They work with a range of patients, from children who have experienced abuse to elderly people in hospice care. They can advocate and obtain care for individuals who need long-term hospitalization, as well as provide an immediate plan for current patients. Ethical, legal, and financial decisions often fall to nurse case managers, and they must be able to make informed decisions regarding patient care.

Duties and Responsibilities of Nurse Case Manager

The duties and responsibilities of nurse case managers range from assessing new patients and creating case management plans for screening communities and populations for healthcare needs. Nurse case managers must regularly communicate with medical professionals regarding patients’ needs and care preferences while documenting and updating information on case management plans for patients. As part of their financial responsibilities, nurse case managers identify patient payment plans and insurance coverage.

Nurse case managers are responsible for discussing current and future treatment plans with patients and their family members, identifying effective plans for ongoing treatment processes. In some cases, nurse case managers also communicate with professionals beyond the medical field, such as social workers, to make case management plans for communities.

Necessary Skills of Nurse Case Managers

One of the most important skills nurse case managers must demonstrate is oral and written communication. Nurse case managers collaborate with professionals in the medical field and beyond, including patients, families, nurses, physicians, administrators, and social workers. Nurse case managers need project management, problem-solving, and conflict resolution skills, in addition to empathy for medically vulnerable patients.

Due to the important decisions nurse case managers make about patients’ lives, they should have a deep understanding of how to provide effective care for diverse populations and experience working with patients of every age and stage of life. They also need to develop a foundation of technical skills in order to run and monitor data analytics, maintain electronic health records, and use other advanced software and systems.

Professional Environments of Nurse Case Managers

According to the U.S. Bureau of Labor Statistics, 33 percent of nurse case managers work in state and local hospitals. Others work in physicians’ offices or government organizations. Though not as common, nurse case managers may also work in outpatient medical facilities.

How to Become a Nurse Case Manager

Nurse case managers are responsible for planning and providing efficient and high-quality healthcare. They hold an important position in the medical field as they help oversee the ethical, legal, and financial aspects of case management plans. Therefore, becoming a nurse case manager requires both education and experience.

Pursue an Advanced Education

Aspiring nurse case managers can begin by earning a bachelor’s degree, usually a Bachelor of Science in Nursing (BSN). Then, they can earn a master’s degree in nursing, health administration, health management, or a related field. Advanced practice registered nurses with a master’s degree and a specialized advanced education, attained through post-master’s certificates, are among the most qualified nurses for the role of a nurse case manager. Social workers and administrators who have worked as nurses can complete a general MSN or MSN in Nursing Administration programs to qualify for careers as nurse case managers.

Gain Work Experience

After earning a BSN and passing the NCLEX-RN exam, registered nurses must gain on-the-job experience working in hospitals, outpatient facilities, physicians’ offices, nursing homes, rehabilitation facilities, or other medical organizations. Individuals looking to become nurse case managers can gain experience as nurses, healthcare administrators, or social workers in healthcare settings or clinical facilities.

Earn Certifications

While policies vary from state to state, a registered nurse looking to become a nurse case manager must be licensed. An RN working as a social worker will need to have a social worker license as well as a nursing license. RNs working as administrators typically need to complete training and pass a national exam.

Salary and Career Growth for Nurse Case Managers

The job outlook for those interested in becoming nurse case managers is good. As of 2018, there were 406,100 jobs for managers in this position and the U.S. Bureau of Labor Statistics projects employment in this industry will grow 18 percent by 2028.

While salaries vary from state to state and differ depending on the professional’s level of education and experience, the Bureau of Labor Statistics reports a median annual salary of $99,730 for medical and health services managers.

The Future of Nurse Case Managers

As patient populations and needs become more diverse, the demand for skilled, capable, and dedicated nurse case managers increases. To ensure effective and quality care for patients, nurse case managers should devote time to pursuing higher education and gaining experience in healthcare environments.

Registered nurses, social workers, health administrators, and others who have earned a BSN or ASN can develop the skills necessary to becoming nurse case managers through programs like AdventHealth University Online’s Master of Science in Nursing. The program’s specialized Administration and Leadership track offers courses like Leadership Practice Finance Immersion, Strategic Leadership in Healthcare, Community Health for RNs, and an Evolving Nurse Roles Seminar that help prepare professionals for leadership roles. Learn more about how AdventHealth University Online’s Master of Science in Nursing can help you pursue a rewarding healthcare career and become a nurse case manager.

Recommended Readings

BSN vs. MSN: What’s the Right Path for You?
Nursing Career Paths: What You Can Do with a BSN or MSN Degree
What Do Healthcare Administrators Do?

Sources

American Case Management Association, Certification
Annals of Translational Medicine, “Case Management: An Up-to-Date Review of Literature and a Proposal of a County Utilization”
BMJ Journals, “Effectiveness of Case Management Interventions for Frequent Users of Healthcare Services: A Scoping Review”
Health Affairs, “Care Management for Older Adults: The Roles of Nurses, Social Workers, and Physicians”
Renal and Urology News, “The Importance of Nurse Managers”

U.S. Bureau of Labor Statistics, Medical and Health Services Managers