Nurse case managers coordinate the provision of quality and cost-effective health care services, typically to patients with chronic or long-term conditions. They can work with patients with specific diseases such HIV/AIDS or mental illness, or specialize in children or the elderly. Nurse case managers can find employment in hospitals, hospices, nursing homes and rehabilitation centers.
Using the Skills
A nurse case manager needs strong analytical and problem-solving skills to evaluate the quality of care services his patient receives, identify shortcomings and find corrective measures. This role also calls for good research skills, as he may need to research alternative treatment methods in health care journals and other sources. The case manager must be a proficient coordinator and organizer, as the job involves scheduling the services of a multidisciplinary team that may include therapists, doctors, nurses and social workers. A nurse case manager should also be able to understand complex health care regulations such as the HIPPA Privacy Rule, and effectively communicate with patients and their families.
Coordinating Patient Care Services
Nurse case managers coordinate several health care aspects of individual patients in various settings. In an assisted-living facility, for example, a case manager can oversee the treatment of a patient with a chronic disability. She monitors the delivery of nursing services, ensuring they conform to the patient's treatment plan. If the patient requires medical attention, the case manager schedules doctor appointments and arranges for the patient's transfer to the hospital. Should the patient be unable to pay for medical services, the case manager may liaise with social workers to help in obtaining financial support services.
Advocacy and Other Duties
Another duty of nurse case managers is to advocate for patients' rights. They can do this by educating patients and their families about the services they are entitled to, as detailed in the Patient’s Bill of Rights. For example, the managers can inform patients that health insurance providers cannot reject their applications for coverage based on pre-existing medical problems.
Other duties include maintaining patients' health care records, preparing patients' progress reports, and responding to questions from patients and their families.
Pursue a diploma, associate or bachelor's degree in nursing, pass the National Council Licensure Examination and meet other state-specific requirements to become a licensed, registered nurse. Next, find employment as an RN and, thereafter, apply for case management positions. The American Nurses Credentialing Center offers a nurse case management certification that you can earn to improve your prospects of landing this job. Certification applicants must meet a set of eligibility requirements, including having at least two years of nursing experience and 2,000 clinical hours in nursing case management.
With several years of experience in case management and a master’s degree in this field, you can move into self-employment and become a case management nurse consultant.
According to the job site Indeed, nurse case managers earned an average annual salary of $62,000 as of March 2015.