Job Title: Nurse Case Manager
Education: Associates degree in General Studies, Community College of Philadelphia Diploma in Nursing, Episcopal Hospital School of Nursing Bachelor of Science Nursing Degree, Immaculata University
Previous Experience: I worked as a staff nurse in cardiac unit after graduation for a year, then I went onto working as a gerontology nurse for two years, then worked as a Home Health Field Nurse for three years, then I was called by a commercial insurance company to do case management. I worked five years as a case manager working with the elderly, now I case manage members on Medicaid.
Job Tasks: My company provides health insurance coverage for people who are on Medicaid.
I check my work queue for the day, review the hospital census, if I have members (people who are insured with us) who are in my assigned hospital I review the hospital summary, place a call to the member, and once they are discharged I call them to review thier discharge instructions. I am responsible for making sure members in disease-specific case management get certain tests done, follow up with a specialist, make sure they have the required vaccinations.
I also assist the members with finding new doctors, making sure they are taking their medications, assisting with transportation. I teach them about their disease process, signs and symptoms to report to their doctor or nurse practitioner which is done over the phone and sending the member patient information to thier home.
Most of my time is spent talking with the members and doing care plans for each member that is enrolled in a disease-specific program, which are diabetes, congestive heart failure, asthma/chronic obstructive pulmonary disease (copd) and general case management. I provide case management for members who are more at-risk for hospitalization or serious, permanent or long-term effects from their disease. I interact regularly with the telephonic case managers, disease managers and social workers, coordinate care for members, and manage members with complex and multiple needs to ensure they receive appropriate healthcare.
I am responsible for the overall plan of patient care for a specific patient population. I coordinate appropriate resources to facilitate and ensure the member's progress through the continuum of care from pre-hospital admission to post-hospital care. I am responsible for assessment, planning, coordination, implementation, evaluation and completion of the care plan.
Best and Worst Parts of the Job: The best part of my job is reaching out to the members. The worst part of my job is when I am unable to reach a member because they either moved, phone number has changed or it was disconnected.
Job Tips: If you plan to have a career in nursing, do it only if you truly care about taking care of people. You will eat and breathe nursing school, its hard work but at the end its well worth it. Don't get into this field for the money, it will backfire on you.
Additional Thoughts: Nursing education does not stop once you pass the state boards, you have to stay abreast of what is going on. You can subscribe to nursing journals, take nursing continuing education (CE) courses which is now mandatory in the state of Pennsylvania.
Click the Visit School Site buttons to go directly to a school's website and learn more about the school and programs it has to offer. School website will open in a new tab. .
Click the Request Info buttons to request more information from a representative at the school
There's still time to apply to Grand Canyon University and pursue your education. Learn more today!
West Coast University
Unitek College™ is a privately held vocational school dedicated to helping you gain the skills needed to advance your career or begin a brand new career.
About Brightwood College
Brightwood College offers accelerated programs that combine flexible schedules and professional instruction to create a rewarding learning experience for individuals focused on gaining the skills for specific careers. Brightwood College is owned and operated by Education Corporation of America.
Turn your talents into a career at nationally recognized and accredited Platt College.
Saint Mary's University of Minnesota's Online Master's Programs
At Saint Mary's, we take pride in offering online graduate degrees designed to complement the schedules of working adults like you. Get an affordable, convenient education from a top-ranked university that's grounded in real-world applications.
For over 35 years, Keiser University has maintained a practical, hands-on approach to career education to help our students achieve their personal and professional goals.
Established in 1897, Bradley University is a private, independent institution of higher learning in Peoria, Illinois. Inspired by our founder, notable philanthropist Lydia Moss Bradley, we pursue excellence in teaching, research, scholarship and service; and we celebrate leadership, integrity, diversity and collaborative learning.
With over 80 years of academic achievements, Jacksonville University is a traditional, longstanding institution consistently ranked by U.S. News & World Report as one of America's best colleges.
Earn your graduate degree online with Northcentral University.
The inside stories from people actually working in the field.
Click a story title to show the story, and click the title again to hide it.
Career Stories are concise, real-world career overviews written by people relating their personal career experiences and wisdom. They provide invaluable insights and mentoring advice to students and career changers.
Most stories include:
Please also see our detailed information about Registered Nurses, including: