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Role of Case Managers in Nursing

Posted on July 24, 2018 by Justin Head

In the United States, there are almost 4 million registered nurses in the workforce. Not all RNs work in direct patient care, however. Upon graduation there are many professional avenues available to a person with a nursing degree.

A close friend of mine is a registered nurse and currently a case manager with a hospital system in Pennsylvania. He truly enjoys his job and finds it to be a very rewarding experience. He loves meeting with patients and their families to assess, plan, implement, and evaluate patient care. He plays a key role in getting certain medications and further treatment approved for the patient, such as a skilled nursing facility or rehabilitation center. The overall goal is to get the patient approved for the appropriate level of care necessary.

Case Management Nurse Career Information

Case management nurses are registered nurses. Some of their responsibilities include:

  • Coordination of all aspects of the care of individual patients
  • Providing care in hospitals and in communities
  • Meeting complex patient needs, including obtaining services for people who need long term care or home care after hospitalization
  • Ensuring ethical and legal issues are addressed, while making sure patients receive medically appropriate services
  • Reviewing charts and meeting with other health care professionals to ensure that patients receive appropriate levels of care
  • Facilitating the admission and discharge processes

Case management nurses must be registered nurses. Most have a Bachelor’s or advanced nursing degree; however many case managers possess a diploma or Associate’s degree in nursing. Case management certification is available and desirable, especially by insurance companies and hospitals. Many case management nurses enter the field via on the job training and continuing education opportunities offered in the community or online.

Challenges of Being a Case Manager

  • Case management nurses must balance patient care with fiscal responsibility for the organization where they work.
  • It is a collaborative process, working with physicians, patient care nurses, and a wide range of medical and non-medical professionals.
  • It is important to be highly knowledgeable in public and private insurance reimbursement policies regarding healthcare.

I personally have many family members and friends who are registered nurses and have a profound admiration for what they do on a day-to-day basis. If you are currently a registered nurse interested in other career paths to explore within your respective field, please take some time to review case management.

Here at Pocket Nurse, a nurse-owned-and-operated company, we take great pride playing our role in assisting healthcare education professionals tasked with the assignment of shaping the minds and lives of future healthcare professionals.

Justin Head is Regional Territory Manager for the North East region. Follow him on Twitter, @JustinH_PN. 

Source:

Nursing Explorer, Careers, Case Management Nurse

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