RN Case Management: Requirements, Travel Jobs and More
By Debra Wood, RN, contributor
As the healthcare industry becomes more focused on value-based care and stellar patient outcomes, RN case managers are playing important roles in delivering smoother transitions.
“We are focused on ensuring the continuum of care in a healthcare journey is seamless and safe,” said Marlene Bober, RN, MHA, ACM-RN, senior vice president of client services and professional practice at the American Case Management Association (ACMA).
As value-based reimbursement becomes more common and care continues to move out of the hospital setting, case management will become more and more important to help patients with transitions, said Rebecca Perez, MSN, RN, CCM, senior manager of education and strategic partnerships at the Case Management Society of America and CMSA Foundation executive director.
Find RN case manager travel assignments across the U.S.
Case management nurse role
Case managers assess the clinical, psychosocial, financial and spiritual needs of the patient, according to the ACMA Case Management Standards of Practice & Scope of Services. Then the RN case manager works with the patients and caregivers in goal setting and developing a plan of care; identifies barriers to achieving the goals; and coordinates resources to accomplish the plan of care.
Then RN case managers will follow through to ensure the care was delivered and results were as expected, Perez said.
“I loved it, because it gave me an opportunity to work closely with patients, families and their support systems,” Perez said of her case management experience. “We helped and educated people, so they could go home and manage their own condition. … When you have a success, it’s so wonderful.”
Case management nurses help to ensure good throughput in the patient population in hospital units to prevent boarding in emergency departments, Bober said.
Trending now are case manager jobs in emergency departments, which can help prevent unnecessary hospitalizations, by developing a plan for home healthcare or community-based services after the patient is medically stable.
RN case managers may work in acute care or long-term care settings, insurance companies, accountable care organizations or case management companies, and physician offices or clinics. Social work case managers tend to focus on psychosocial support and legal issues, while case management nurses focus on ensuring clinical needs will be met. That might include confirming the patient has a place to live and food.
Healthcare is moving to the outpatient and community setting, which keeps people out of the hospital, Perez said. That requires case management nurses for care coordination and a focus on good transitions of care.
The COVID-19 pandemic and the increase in virtual visits increased the need for case management, Perez said.
Some RN case managers also may perform utilization review, making the case for the admission’s medical necessity and ensuring the documentation is complete.
Essential qualifications for an RN case manager
RN case managers, typically, have several years of acute-care experience, often from intensive care or emergency departments, before transitioning to case management nursing.
The 2021 CMSA State of the Industry Survey found nearly 85 percent received on-the-job training. Caseloads ranged from 11 to 30 patients. More than 40 percent earn between $75,000 and $100,000 annually.
Case management nurses also must be good multitaskers, able to prioritize and possess strong organizational skills.
Flexibility and the ability to plan alternative solutions are key skills, Perez said.
Critical-thinking skills and the ability to collaborate with patients, families and the healthcare team are essential, Bober said.
“It takes teamwork, and I see [a case manager] being a leader and an advocate for [the patient],” Bober added.
Case management nurses also must understand different regulatory and reimbursement structures and be ready to advocate for coverage and look for resources, Perez said.
Perez added that case management nurses also must be willing to research new or unfamiliar diseases, including behavioral health conditions.
“You have to open yourself to learning,” Perez said.
RN case manager jobs
The outlook appears strong for the demand for RN case managers.
ACMA and CMSA offer many resources for case managers, including educational programs, best practices in the specialty, networking and benchmarks.
ACMA provides resources, “so case managers have the tools to do their job in a successful fashion,” Bober said.
Case manager jobs often require certification in the field. The CMSA State of the Industry Survey found 83 percent of employers require certification.
“Certification demonstrates you have not only the education and experience but also the professional practice behind you,” Bober said. “It validates clinical decision making and competency in transitions of care.”
Hundreds of case management travel nursing jobs can be found from one end of the country to the other. Assignments, typically, last from four to 26 weeks. Although the employer sets the pay rate, which varies by location, seasonal fluctuations and experience, case manager travel nurses can make more than $2,000 per week, including reimbursements for housing and travel.
Travel nurse case managers get to see the country, work with patients and avoid serving on committees and other responsibilities of permanent staff.
Knowing they have done their best to improve someone’s health and well-being gives case management nurses satisfaction.
“It’s rewarding in seeing the impact you have made in promoting the understanding of patient goals and helping [patients] achieve what they need on their healthcare journey,” Bober said.
TravelNursing.com has exciting travel assignments for case managers across the U.S.
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