How to Become a Managed Care Nurse

Managed care nurses help patients enrolled in a managed care plan to receive quality, cost-effective care. The steps to become a managed care nurse include education, testing, and licensing, after which managed care nurses can pursue employment. Below, we’ll detail the steps to follow, how long it takes to become a managed care nurse, and where to start.

Become a Managed Care Nurse in 5 Steps

To become a managed care nurse, candidates must first become licensed registered nurses (RNs). While not mandatory, they can pursue certification in a specialty after a few years of bedside experience.

Schooling Requirements for Managed Care Nurses

Managed care nurses must be registered nurses, a title earned by graduating with an ADN or a BSN degree.

Associate Degree in Nursing

An Associate Degree in Nursing, or ADN, is the quickest option to become a managed care nurse with no previous university education. ADN degrees can take 18 months to two years to complete and may require some prerequisites before an application can be accepted.

Managed care nurses with an ADN may receive lower pay and may not have their first choice of positions compared to those with a BSN.

Bachelor of Science in Nursing

A Bachelor of Science in Nursing (BSN) gives future managed care nurses a well-rounded education experience. Typically completed over four years, the BSN curriculum covers the basics of nursing care and how the body works, but also teaches more specialized critical thinking skills.

A BSN prepares aspiring managed care nurses to handle a high level of critical thinking. This degree teaches high-level concepts like evidence-based practice, community health nursing, statistics used in research, nursing management and leadership, health informatics and analysis, healthcare ethics, and nutrition.

Managed Care Nurse Licensing

Once a new nursing graduate has earned their degree, they must apply for licensure. Managed care nurses must apply for a registered nurse license to practice. To become a licensed and practicing nurse in any state, all nursing graduates must pass the state licensing exam (the NCLEX-RN) and apply for a state license.

NCLEX-RN

The National Council Licensure Examination–RN (NCLEX-RN) is a computer-based exam with 85 to 150 questions. The exam takes anywhere from one hour to a maximum of five hours. Questions fall into four basic categories:

1. Safe and Effective Care Environment
2. Health Promotion and Maintenance
3. Psychosocial Integrity
4. Physiological Integrity

Once completed, the state board of nursing sends test results within six weeks, usually by email. In the time leading up to the NCLEX-RN, it’s important for graduates to study practice questions to ensure a passing grade and many students take NCLEX prep courses to increase their likelihood of success.

Registered Nurse State License Application and Renewal

Each state in the U.S. has a unique registered nurse licensing application process. The state board of nursing will want to see proof of an NCLEX passing result and a diploma from an accredited nursing program. Most states require criminal background checks and fingerprinting, and some may want to see university transcripts.

In most states, RNs must renew their license every two years after initial licensure. Each state has varying requirements for continuing education and other documentation needed for renewal. The National Council of State Boards of Nursing offers a wealth of information on registered nurse licensing requirements by state.

Specialty Certification

Managed care nurses may choose to pursue specialty certifications through the American Association of Managed Care Nurses (AAMCN), which offers the Certified Managed Care Nurse (CMCN) designation.

Where Do Managed Care Nurses Work?

Managed care nurses can find employment in a wide range of organizations. These may include:

• Community health centers
• Government agencies
• Health management organizations (HMOs)
• Medicaid and Medicare
• Preferred provider plans (PPOs)
• Social services programs
• Specialty clinics
• Telephone triage centers

FAQs: How to Become a Managed Care Nurse

   1. What education is needed to become a managed care nurse?

Managed care nurses must graduate with a nursing degree from an accredited college or university. They can pursue a two-year Associate Degree in Nursing (ADN) or a four-year Bachelor of Science in Nursing (BSN).

   2. How many years does it take to become a managed care nurse?

The time it takes to become a managed care nurse depends on which degree one pursues, but may take anywhere from two to four years for an undergraduate degree.

   3. What are the steps to become a managed care nurse?

To become a managed care nurse, candidates must apply to and graduate from an accredited nursing school, pass the NCLEX-RN, and apply for and receive a nursing license in their state. After these steps, they may apply for managed care nurse positions and pursue specialty certification.

   4. How much do managed care nurses make an hour?

According to the U.S. Bureau of Labor Statistics (BLS), managed care nurses fall under the social and community services category. They earn an average of $40.10 per hour, which equals about $83,400 annually. Nurses with an advanced degree can earn more.