What does a RN Case Manager do?
Registered nurse case managers are responsible for coordinating patient care services. They help determine the type of care needed and the steps that must be taken to ensure that the patient receives that care. Other responsibilities can include scheduling appointments, determining insurance eligibility for certain treatments and performing exams and evaluations. Registered nurse case managers typically have clinical experience and begin their careers as registered nurses who care for patients daily. After, they can progress to higher levels of management. They can work in hospitals, nursing homes and other health care facilities.
To become a registered nurse case manager, you should have at least an associate's degree in nursing. Some jobs may require a minimum of a bachelor's degree. For all jobs in this field, you need to have a valid registered nurse license, which must be obtained by successfully completing a nursing program and passing a licensing exam. Registered nurse case managers should have extensive health care knowledge, strong interpersonal skills and the ability to clearly communicate decisions.
- Use clinical tools, data and other information to complete assessments of patient needs
- Create individualized and comprehensive case management and treatment plans
- Determine insurance eligibility for various treatments and treatment programs
- Clearly explain the reason for prescribed treatments and treatment plans to patients
- Educate patients on benefits, services and other resources, including payment options
- Communicate with patients, physicians and insurance companies to secure successful outcomes
- Document complex medical information to outline and improve health results
- Follow case and quality management processes in compliance with regulatory guidelines and company procedures
- Associate's or bachelor's degree in nursing, with a bachelor's degree preferred
- Active nursing license in the state in which you will be based
- Clinical knowledge of chronic conditions, such as diabetes and congestive heart failure
- Strong written and verbal communication skills with patients, physicians and other stakeholders
- Demonstrated ability to assess and respond to patient and family needs in a timely manner
- General knowledge of case management practices, including familiarity with relevant products and services
- Basic computer skills, including working knowledge of the Microsoft Office suite
- Experience in establishing professional and collaborative relationships with patients, doctors and insurance providers
- Certification as a diabetes educator, nutritionist, physical therapist or other specialty is a plus
How much does a RN Case Manager make near United States?
RN Case Manager Career Path
Learn how to become a RN Case Manager, what skills and education you need to succeed, and what level of pay to expect at each step on your career path.
Years of Experience Distribution
RN Case Manager Insights
“I am very happy with my job and love all the people I work with.”
“Thi was not the worst training in my nursing career but in my entire working career!”
“The pay was fair to good but wasn't always paid out accurately or timely.”
“I love working for JRHH it is a great place to work with people who truly care.”
“You will take at least 1 PTO day monthly for being run down 5. No work life balance.”
“$ is good and compensation is high if you want to see additional patients.”
“Very difficult to earn good raises and bonuses.”
“Travel nursing is very new to me and I was blessed to work with an amazing recruiter Christina.”
RN Case Manager Interviews
Frequently asked questions about the roles and responsibilities of a RN Case Manager
- Registered Nurse
- Nurse Practitioner
- Clinical Instructor
- Nurse Manager