RN case managers are registered nurses who are responsible for the coordination of the various elements that are involved in the care of an individual patient. Their role is to use resources and services in the best way possible. They assist inside facilities, outside facilities and between different care environments. As a case manager, RNs must focus on using strategies that are fiscally responsible, meaning they know how and where to get the necessary resources to deliver excellent care at a cost that is affordable. They will work together with patients and their families, but also with other physicians and partners such as the pharmaceutical and medical technology industry, as well as with insurance companies. As such, a case manager must be an excellent communicator and have fantastic creative and organizational skills.
About RN Case Managers
RN case managers are at the very least a registered nurse. This means that they must at least hold a bachelor of science in nursing (BSN) or associate’s degree in nursing (ADN). It is desirable and advisable to also obtain case management certification, although this is not required. In many cases, nurses become managers through job training. However, insurance companies and hospitals, in particular, are starting to require more extensive certification. In most cases, a case manager will also hold a master’s of science in nursing (MSN) degree and some are now even continuing on to their doctorate degree.
In recent years, the American Association of Critical-Care Nurses (AACN) has made a position statement that case management nurses need to have at the very least a BSN, meaning that it is now increasingly rare for someone with an ADN to become an RN case manager. Three options exist to become an RN. These are:
- The nursing school that is hospital based, where a degree will take four years.
- Achieving an ADN in two years, followed by a further two years of studying to obtain a BSN. Some nurses choose this as it gives them the opportunity to have a break in studying between the two degrees. This is often more flexible and more financially viable as well as a degree is a big investment.
- Obtaining a BSN through any other university.
Additionally, some accelerated programs exist for people who hold a bachelor’s in a non-nursing field. This takes between one and two years to complete, depending on the field of the original bachelor’s degree.
After completing their education, prospective nurses must take the NCLEX-RN examination. This allows them to become a registered nurse, after which they can continue on to their MSN. Within the MSN pathway, there are a number of popular specializations, each of which can be beneficial to someone who wants to be an RN Case Manager. The most popular specializations are:
- Urgent Care
- Surgical Nursing
- Pediatric Nursing
What Jobs Does This Lead To?
RN case managers are charged with assessing, planning, implementing and evaluating the care of patients and how resources were used to achieve this. They look into the quality of care and they make sure that risk management and infection control policies are in place. They are true advocates for the patients, their families, the insurance companies and the facilities in which they work. In many cases, a case manager will work directly with patients who are moving from or to facilities such as assisted living or nursing homes. They also often work with accident victims and inside hospices. Furthermore, they often work with patients who have substance abuse and/or mental health problems and victims of neglect and abuse.
Because of the breadth and scope of practice, RN case managers can be found everywhere. Their services are highly diverse and include ensuring medically at risk children are provided the right services. Many insurance companies also hire case managers, as do rehabilitation services. Their specialty is in the entire field of nursing, which means they can work in anything from long-term care to disease management and from hospice to home health care.
In terms of working hours, most RN case managers work during the day on week days. However, as the profession changes, there are increased requirements for case managers to work in shift patterns. Furthermore, there is a high demand for these professionals in remote and underserved locations. Nurses who enjoy field work, for instance by working in disaster management, are particularly suited to the role of case manager. Finally, some case managers are able to work from home at least partially.
It is important for case managers to be able to understand laws and regulations and they must have excellent computer skills. In their job, they will spend a lot of time sitting down, compared to other nurses who work on wards. However, they do have to be able to oversee the care of patients and they must be able to do this from a variety of perspectives. At the heart of their function lies the needs of the patients, but they must also respect the family, the wider community and the various reimbursement requirements.
The central role of RN case managers is the coordination of proper care. As such, they can be involved in both short- and long-term care, and they can work in various different settings. However, if employed in a hospital, the following duties are common:
- Evaluating any patients that are admitted to hospital.
- Being involved in the preparation and implementation of care plans, both in terms of in-patient and out-patient care.
- Communicating between patients, their families and insurance companies.
If RN case managers work for an insurance company, however, their role will be very different. Here, they will often do clinical and performance reviews and they will plan the discharge of patients. Furthermore, they will design care that is needed after discharge in a way that is beneficial for both the patient and the insurance company.
Finally, some RN case managers take responsibility for geographical locations rather than single health care settings. In these cases, their role will be to coordinate between the different parties that are involved in health care. Here, they will have to travel frequently, although it is also much easier to do large proportions of work at home.
The median salary for registered nurse case managers is $64,000. The lowest 10% earn $47,830 or below, and the top 10% earn $83,370 and above. The top 10% tend to be those with the highest levels of education, including doctorate degrees. However, geographical location and the number of years of experience someone has are also important factors. The largest hospitals tend to offer the highest salaries and the lowest salaries are offered to those who work for voluntary organizations.
Job Outlook for RN Case Managers
Managed care and budget cuts are at the forefront of health care. Because of this, RN case managers are in high demand and the opportunities for employment are set to increase. Indeed, case managers are some of the most desirable people within the field of nursing and this means that there is strong competition for employment. This is why those who want to work in this field should seriously consider obtaining their MSN degree and to specialize in case management so that they are able to get a foot in the door.
At the same time, it is expected that there will soon be a shortage of qualified case managers. This is due to the aging workforce and due to the fact that there is significant employment growth in the field of health care. Additionally, there are now more and more ACOs (accountable care organizations), which is further fueling demand. According to the U.S. Bureau of Labor Statistics, growth in the entire field of nursing is set to be well above the national average and it is believed that RN case managers in particular will see highly significant growth.