How to Become an RN Case Manager

Nursing is a rewarding, versatile profession with numerous career opportunities. If you’ve heard about the RN case manager role but aren’t sure what it is — you’re not alone.

We can help answer all your questions about this non-clinical nursing role, whether you’re an aspiring nurse planning your career path or an experienced nurse looking for a new position in management. We’ll help you learn how to become a case manager RN, with an overview of what they do, their education requirements, how much they make, and more.

What Is a Registered Nurse Case Manager?

The nurse case manager is a registered nurse who coordinates the plan of care for their panel of patients. They’re pivotal for ensuring that patients promptly receive cost-effective treatment and resources to optimize their health and reduce hospitalizations. They facilitate this by collaborating with the patient and their family, the multidisciplinary team of medical professionals, and the insurance provider to identify and resolve barriers to healthcare.

What Does an RN Case Manager Do?

The case manager is responsible for coordinating the various aspects of the healthcare system to make sure the patient receives the appropriate care without anything falling through the cracks. Typical duties include:

• Serving as the patient’s advocate
• Assessing, developing, and implementing the patient’s plan of care with a multidisciplinary team based on the patient’s ongoing needs
• Providing patient and caregiver education regarding their health conditions
• Scheduling patient’s physician and practitioner visits, testing, and treatment appointments
• Connecting patients to services and resources to meet goals
• Managing patient outcomes through quality care and cost-effective treatment plans
• Obtaining insurance authorizations and meeting reimbursement requirements
• Communicating and collaborating with the patient and their family, multidisciplinary team, and insurance providers
• Decreasing hospitalizations for high-risk patients

RN Case Manager Education

There are some hurdles to clear before case management nurses can work with patients and other clinicians to promote quality, cost-effective care. Your first step to becoming a nurse case manager is to complete an accredited nursing program to obtain a two-year associate’s degree in nursing (ADN) or a four-year bachelor of science in nursing (BSN) degree. If you have a non-nursing bachelor’s degree, you also have the option to complete an accelerated BSN program, which can take eleven months to two years, depending on the program.

Once you have your ADN or BSN degree, your next step is to take the National Council Licensure Examination for Registered Nurses (NCLEX-RN). After you pass the NCLEX-RN, you can apply for and obtain your RN license through your state’s board of nursing.

The third and final step in your preparation to become a nurse case manager is to round out your training by gaining nursing experience at the bedside. Employers require a range of one to five years of RN clinical experience as a prerequisite to apply for their nurse case manager positions.

Keep in mind, where you obtain your clinical experience can strongly influence where you will work as a case manager. For instance, if you aspire to perform case management in an acute patient care setting, working as an RN in the emergency department, intensive care unit, or medical surgical floor will make you a more competitive candidate than working at a home health agency.

Case Manager Certification

After you work as a nurse case manager for one to two years, pursuing your certification in this field is strongly recommended. Certification will help you enhance your skill set, demonstrate your dedication to the profession, and potentially increase your salary. It will also make you more marketable, as many employers require experienced case managers to have their certification to be considered for open positions.

Eligibility to apply for initial certification and renewals varies depending on the certifying board. Requirements typically consist of an active and unrestricted RN license, minimum case management hours, continuing education hours, and RN experience. Organizations that offer certification include:

• American Case Management Association (ACMA) — Accredited Case Manager (ACM)
• American Nurses Credentialing Center (ANCC) — Nursing Case Management Certification (CMGT-BC)
• Commission of Case Manager Certification — Certified Case Manager (CCM)

What Are Some Good RN Case Manager Skills to Develop?

Many key skills are essential for the nurse case manager position. Some skills come naturally, while others take time and experience to develop. Here are the top case management skills that you can begin cultivating in school and as an RN:

• Emotional intelligence
• Cultural sensitivity
• Communication
• Collaboration
• Leadership
• Problem-solving
• Patient advocacy

How Long Does It Take to Become a Case Manager RN?

The time it takes to become a nurse case manager varies depending on your chosen career path. It takes two to four years to complete your nursing education and obtain your RN license, and an additional one to five years of RN clinical experience. In total, it will take three to nine years from starting nursing school to reaching your career goal.

Where Does an RN Case Manager Work?

Once you complete education requirements, you can get your RN case manager resume ready and apply for jobs. As a nurse case manager, you can work in various settings across the spectrum of healthcare based on your interest and experience. Depending on the position, case managers typically work in clinical settings, in the field, or remotely from home. Locations include:

• Acute care facilities — academic teaching hospitals, community hospitals, medical centers, etc.
• Post-acute care facilities — long-term care hospitals, inpatient rehabilitation, recuperative care facilities, nursing facilities, home health agencies, etc.
• Clinics — primary care or specialist offices, behavioral health centers, public health or community centers, etc.
• Hospice — inpatient units, dedicated centers, and home services
• Health insurance companies — Medicare Advantage and commercial providers

How Much Does a Nurse Case Manager Make?

The average salary for medical and health services managers of $134,440 per year. However, this figure can vary greatly depending on the nurse’s education, years of experience, job setting, and geographical location.

The job outlook for this position is likely in line with that of registered nurses, which is an increase of 6% in the next decade. That figure is faster than the average for all other occupations. The reason for the job growth is due, in part, to the aging population and the need to provide them with medical care.

Ready for Your Next Nursing Opportunity?

Whether you require more work experience to become a nurse case manager or a different work schedule to pursue certification, we have you covered. Search IntelyCare today for the best nursing and RN case manager jobs that meet your needs.