How to Become a Nurse Case Manager

Are you passionate about managing patient care and outcomes, collecting data, and implementing educational programs? Then, a nurse case manager career may be a great fit.

Nurse case managers play an important role in healthcare delivery. They manage care for patients who need extra support by planning and identifying realistic goals. They also coordinate care by working closely with healthcare teams. Explore how to become a nurse case manager, including the required education, experience, and skills.

When a patient is assigned a nurse case manager, the nurse case manager is responsible for coordinating care and creating care plans that support the patient’s recovery. They collaborate with healthcare teams, payers, and families to ensure optimal patient care.

Nurse case managers must also discharge patients safely to a designated location, such as a patient’s home, a long-term care facility, or a senior living or group home.

Nurse case managers advocate, negotiate, and streamline care for patients. Their cases typically involve patients with serious injuries, disabilities, or those who need help with navigating complex and or chronic conditions. For example, a nurse case manager’s duties may include:

Nurse case managers work with a broad spectrum of patients, including infants, pediatric, adult, and geriatric patients. They work in hospitals, long-term care facilities, hospice clinics, or insurance companies.

To become a nurse case manager, you must take several steps as a registered nurse (RN). Nurse case managers are experienced RNs skilled in managing care and solving problems. Communicating with patients, families, and other healthcare team members is an essential skill.

New RNs can work with more experienced case managers to gain the experience necessary to apply for nurse case manager jobs and become board-certified.

Nurse case managers need a valid and unrestricted RN license. Although a two-year ADN degree is the shortest pathway to licensure, many employers require or prefer nurse case managers with four-year BSN degrees.

Once you pass the NCLEX, you are licensed with your state’s board of nursing and can practice as an RN in that state. State nursing boards determine the criteria for issuing and renewing RN licenses. Requirements to maintain a license vary by state.

Becoming a certified nurse case manager demonstrates credibility and holds nurses to the highest standards of ethics and care. To be eligible for certification, nurses need certain qualifications. For example, the Commission for Case Manager (CCM) certification requires:

Although there is no legal requirement that a nurse case manager be certified, some employers prefer or require it.

Nurse case managers are in demand around the country.

In addition to robust professional growth, nurse case managers can command an average yearly salary of $98,869, according to data from ZipRecruiter. (Salaries vary by geographic region, workplace, responsibilities, and other factors.)

Nurse case managers often begin their careers as bedside nurses but can start as case managers if a certified case manager supervises them. After gaining experience, nurse case managers coordinate care for their caseloads.

Nurse case managers can work in various settings, including healthcare facilities, insurance companies, long-term care facilities, home health, and hospice clinics. They are closely involved in family education and support, discharge planning, and connecting patients with resources.

Case managers working for insurance companies or other payers will likely focus on developing care plans and coordinating care for complex cases.

Page last reviewed July 11, 2024