Nursing

What Is a Nurse Case Manager? Outlook and Path

NursingFebruary 29, 2024

Registered nurses (RNs) take on many critical roles in the healthcare system. They care for patients with acute and chronic health conditions, perform diagnostic tests, and educate patients on managing their health. Nurses also act as case managers. What is a nurse case manager though?

Nurse case managers connect patients with healthcare services. As patient care coordinators, case managers help patients meet their health needs while also advocating for patient safety and care quality.

Case management roles provide work-from-home opportunities and the potential for higher earnings. Experienced nurses who hold an advanced nursing degree can pursue careers as nurse case managers.

Nurse Case Manager Job Responsibilities 

While most registered nurses provide clinical care for patients, a nurse case manager is more focused on administrative responsibilities. Case managers coordinate care for patients, acting as a liaison between patients, insurers, and healthcare providers.

Effective nurse case managers help patients and their families understand their medical options. Patient education represents a key job responsibility for nurse case managers. 

Nurse case managers bring clinical skills to their role. Depending on the setting, they may perform health assessments or evaluate patients. Most jobs require a valid RN license.

Depending on the workplace, case managers may also be called care managers, care coordinators, or patient advocates. Specialized roles include hospital case manager, home health case manager, health insurance case manager, and rehabilitation case manager.

Case Manager Work Settings

Nurse case managers work in several employer settings. According to a 2022 survey by the Case Management Institute (CMI), 41% of case managers work in managed care or health plans, while 31% work in hospitals and acute care settings. They also work in outpatient care, rehabilitation, behavioral and mental health, and other healthcare settings.

Case managers also work in several different workplace environments. While around half work in clinical and office locations, 49% report working from home, according to the CMI survey. 

The responsibilities of nurse case managers often include traveling to connect with patients and other healthcare providers. They may also include educating patients and members of the community in various settings. 

Key Case Manager Skills

Nurse case managers rely on their communication and organizational skills to connect patients with care providers and coordinate care. For example, case managers regularly interact with patients, family members, insurance agents, and healthcare professionals. Strong communication skills allow case managers to effectively advocate for patients.

Because nurse case managers often take on a caseload that includes multiple patients, the role requires an organized and detail-oriented approach. The ability to create action plans, educate patients, and comply with regulations also benefits nurse case managers.

Steps to Become a Nurse Case Manager 

Careers in case management require a mix of education and experience. For example, a majority of nurse case managers hold a bachelor’s degree and professional certification, according to the CMI report. The steps below prepare candidates to become nurse case managers.

1. Become an RN

A licensed RN is an essential part of what a case manager is. Currently, 86% of case managers are RNs, while social workers make up 9% of case managers, according to CMI. 

Nurses need at least an Associate Degree in Nursing (ADN) or, less commonly, a nursing diploma to become an RN. After completing coursework and clinical requirements, candidates must pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) and apply for their RN license through their state board of nursing.

2. Earn a BSN or an MSN

Most case managers hold a bachelor’s degree or a graduate-level degree. Just 15% of case managers have an associate degree as their highest level of education, while 52% hold a bachelor’s degree and 30% hold a master’s degree, according to CMI. This indicates that earning a Bachelor of Science in Nursing (BSN) or a Master of Science in Nursing (MSN) can help RNs become nurse case managers. 

RNs with an ADN can advance their education through an online RN to BSN program, which can be completed in as little as 15 months (with required prerequisites). RNs who already hold a BSN can enhance their credentials by enrolling in an online MSN program, which can be completed in as little as 15 to 18 months. Prospective nurse managers who are not already RNs may enroll in four-year BSN programs or BSN completion programs, which can be completed in as little as 21 months (with required prerequisites).

3. Gain Work Experience

Case managers typically bring several years of clinical experience as a nurse. They may work in hospitals, community health organizations, or other healthcare settings. Patient care experience helps nurses build the communication skills required for careers in case management.

Experience in patient care coordination or discharge planning benefits prospective case managers. Similarly, gaining leadership and management experience helps RNs move into case manager roles. 

4. Apply for Board Certification

While professional certifications are voluntary, they can help nurse case managers expand their career opportunities. For example, 67% of respondents in the CMI survey held a professional certification. The survey also found that 33% of employers required certification, while 32% encouraged but didn’t require certification.

Nurses can pursue board certification in nursing case management. The American Nurses Credentialing Center (ANCC) offers the case management nurse – board certified (CMGT-BC) credential to RNs with at least two years of full-time experience and at least 2,000 hours of clinical practice in nursing case management.

Candidates for the ANCC credential must pass a 150-question exam. The certification remains valid for five years.

Demand for Nurse Case Managers

As the population continues to age, demand for healthcare services will increase. RNs will see an estimated 193,100 job postings annually from 2022 to 2032, according to projections from the U.S. Bureau of Labor Statistics (BLS).

Case managers will likewise benefit from strong demand. Patient care coordination will continue to be a key responsibility in hospitals, insurance agencies, and other settings. 

Become a Nurse Case Manager With Denver College of Nursing

RNs can advance their careers and gain flexibility in their work schedules by moving into case management. Take your first steps toward becoming a nurse case manager by earning an advanced degree from the Denver College of Nursing. 

Registered nurses can enroll in the RN to BSN or MSN online programs to advance their education. Or individuals can enroll in the BSN completion option if they hold a bachelor’s degree in a non-nursing field. Learn more about what a nurse case manager is and how the Denver College of Nursing can help you achieve your career goals.

Recommended Readings
Creative Ways to Show Exemplary Leadership in Nursing
Keep Learning: Five Nursing Certifications to Consider Once You Graduate
What Is a BSN Completion Program and How Does It Work?

Sources:
American Nurse Journal, “Exploring Nurse Case Manager Practice”
American Nurses Credentialing Center, Nursing Case Management Certification (CMGT-BC) 
Association of Rehabilitation Nurses, What Does a Rehabilitation Nurse Case Manager Do?
Betterteam, “RN Case Manager Job Description”
Case Management Institute, 2022 Case Management Salary and Trends Survey
U.S. Bureau of Labor Statistics, Registered Nurses
Verywell Health, “Duties and Types of Case Managers”