Case Management Nurse Career Overview
What is a Case Management Nurse?
Case management nurses coordinate patient care as a whole. A single patient may have a handful of doctors who aren’t so great at communicating with one another. Add in a home health agency, a couple of family members who aren’t speaking to each other, and a medical equipment company, and you start to get the picture of a case management nurse’s day.
Sometimes known as nurse care coordinators, case management nurses serve as conductors of each patient’s health symphony. They look at each patient’s overall care from a high level and often spot and prevent aspects of care from falling through the cracks.
Where Do Case Management Nurses Work?
Since they direct patient care throughout the health continuum, case management nurses can work in a large number of settings, including:
- Community health centers
- Doctor’s offices
- Government agencies
- Home healthcare companies
- Hospice
- Hospitals
- Insurance company offices
- Medical supply companies
- Nursing homes
- Outpatient clinics
- Palliative care
- Public health centers
- Skilled nursing facilities
Case management nurses who work for hospitals and skilled nursing facilities may need to work in that location. They often need to stay available for in-person care plan conferences, family meetings, collaboration with the health team, and patient and family education. Private practice and insurance company case management nurses can work from home or the office, depending on their employers’ preferences.
Many case management nurses who work for medical supply companies, hospice, and palliative care can work remotely, but some employers may require a hybrid or in-office schedule. Some may also ask case management nurses to visit patients at home.
What Does a Case Management Nurse Do?
Tasks for case management nurses can differ depending on the employer. In a hospital, a case management nurse may facilitate discharges, coordinate transfers to skilled nursing facilities and rehabs, or arrange home care services. Some common case management nurse responsibilities include:
- Assessing patient medication adherence
- Calling or visiting patients to follow-up after discharge or ER visit
- Collaborating with other healthcare professionals
- Connecting patients to services and resources
- Coordinating transfer to other facilities
- Educating patients and their families about complex medical decisions
- Guiding the discharge process
- Helping patients make doctor appointments
- Identifying high-risk patients
- Managing patients’ long-term care plan for chronic illness
- Providing education to prevent hospital readmission
- Screening patients for healthcare needs
- Serving as a liaison between providers and insurance payors
- Tracking and following up with patients through multiple health systems
Nurses in case management often serve as the point of contact for patients and their families as they move between levels of care. They can also spend a lot of time on patient education. Case management nurses often spend their days talking on the phone or in person, working with the entire healthcare team to ensure patients’ needs are met.
A case management nurse works for their facility and patients equally. A big part of case management lies in cost-saving, both for the facility and their patients. If their education and follow-up can help a patient stay out of the hospital, for example, that’s a win-win for everyone involved.
How Do I Become a Case Management Nurse?
Those who want to become case management nurses must graduate from an accredited nursing program. Most employers require their nurse case managers to have obtained a Bachelor of Science in Nursing (BSN). Most BSN programs require four years of study, but some programs offer accelerated options in which students may earn their BSN in as little as a year.
Once a nurse graduates with their BSN, they will need to take the RN licensing exam: the NCLEX-RN, which is a standardized test that demonstrates a nurse’s knowledge and capability to work in their field. After passing the NCLEX, nurses may apply for a license in the state where they want to work. Different states may require slightly different documentation, but usually, these include college transcripts, a federal background check, proof of passing the NCLEX, and a fee.
Most case management positions ask applicants to have at least two or three years of nursing experience. This experience prepares a nurse for the complex challenges they will face as a case management nurse.
Case management nurses can earn certifications from a couple of different sources.
The American Nurses Credentialing Center offers the Nursing Case Management Certification (CMGT-BC), and requires nurses to have:
- An active RN license
- At least 2,000 hours of clinical practice in nursing case management within the last three years
- Proof of 30 hours of continuing education in nursing case management within the last three years
- The equivalent of two years of full-time practice as a registered nurse
The American Case Management Association offers the Accredited Case Management Credential (ACM). They require nurses to have an active nursing license and at least one year (or 2,080 hours) of paid work experience as a case manager. Candidates with less than two years of experience have to provide supervisor references.
The Commission for Case Manager Certification offers the Certified Case Manager credential and requires applicants to have an active RN license. They also ask for one year of full-time case management experience supervised by a board-certified case manager or 24 months of full-time case management employment experience.
How Much Does a Case Management Nurse Make Per Year?
Case management nurses can make a higher wage than staff nurses once they spend some time in the specialty. Their average annual salary is $77,104, according to Payscale. This number can depend on the type of facility or company that employs them and their state of licensure. Case management salaries also highly depend on years of experience.
Newer nurse case managers may make as little as $62,000, while a case management nurse with decades of experience who live in an area with a high cost of living may make up to $97,000. These numbers from Payscale represent reported salaries, but another source, ZipRecuiter, puts case management salaries much higher, with an average of $102,226 annually.
According to ZipRecruiter, the top-paying cities for case management nurses are:
- San Jose, CA: $132,680
- Oakland, CA: $130,846
- Antioch, CA: $128,288
- Hayward, CA: $126,706
- Seattle, WA: $126,552
- Santa Cruz, CA: $124,221
- Concord, CA: $123,722
- Seaside, CA: $122,130
- Sunnyvale, CA: $121,690
- Livermore, CA: $120,246
A case management nurse’s salary also depends on certifications and education level. A certified case manager with 20 years of experience will earn more than a case management nurse just starting out.
Why Should I Be a Case Management Nurse?
Case management nurses have the power to improve patient outcomes, prevent hospital readmissions, lower healthcare costs, and provide stellar transitions to different levels of care. They can also assist patients in getting better access to care by arranging transportation and blocking any cracks they may otherwise fall through.
Nurses who go down the case management path can work in many different settings and have the ability to earn a higher salary than a bedside nurse. Their schedules typically follow regular business hours, with very few weekends and holidays required. As case management nurses work with patients over a long period of time, many enjoy the relationships they develop and experience high job satisfaction.
Additional Resources About Becoming a Case Management Nurse
To learn more about becoming a case management nurse, these websites offer additional resources:
