Nurse case managers are registered nurses with at least an associate's degree in nursing (some employers prefer a bachelor's or master's degree). In addition to education, nurse case managers must also be licensed in the state of practice. Generally, nurse case managers have at least two years of experience as a floor nurse providing direct patient care before they move into the role of case management. Nurse case managers are employed in a variety of settings, including nursing homes, hospitals, and prison facilities. They work with patients to determine placement when additional services are needed, such as rehabilitation, social services or mental health services. Nurse case managers assess each patient's needs individually and develop a care plan for that specific patient. Nurse case managers are knowledgeable about local resources, which they integrate into the care of the patient. Organization is essential because the case load at any given time may be quite large. They also conduct admission and discharge planning for patients, which may involve coordination of hospital, hospice, rehab and home-bound patients. Nurse case managers must be aware of different insurance plans and the services each covers. Case managers may work a variety of shifts as needed to meet patient care. They work directly with the staff nurses, physicians and other health care personnel to coordinate services for optimal cost savings and benefit to the patient.
Nurse Case Manager Tasks
- Provide utilization management for assigned patient case load.
- Conduct admissions and discharge planning for hospital, hospice or home care patients.
- Assess patient needs and develop a care plan.