Nurse Case Manager

Navigating the medical system can be a daunting prospect for even the most basic healthcare need. Patients with complex medical needs or chronic conditions can quickly become overwhelmed by tracking specialists, medications, appointments, and treatments. Patients who aren’t able to follow through have an increased risk of hospitalization, morbidity, and mortality. Nurse case managers are essential in helping these high need patients in receiving adequate care.

Nurse case managers are registered nurses who have specialized education and training in case management. With medical knowledge and strong interpersonal skills, they advocate for patients’ needs, help schedule appointments, ensure follow-up care is completed, monitor medications, and educate patients. They are often the first person a patient with chronic conditions will turn to with questions or concerns. Nurse case managers must be licensed registered nurses in the state where they practice. Many of them have completed additional education and certifications to demonstrate their proficiency in this field.

Nurses, in general, are in very high demand, according to the Bureau of Labor Statistics (BLS). It is estimated that there will be a 7 percent increase in jobs in this field between 2019 and 2029. This increase is due in large part to an aging population with increased medical needs. According to the BLS, nurses earn $77,460 per year on average.

Read the guide below to learn how to become a nurse case manager, including online and on-campus programs, types of degrees, typical duties, and admission requirements.

There are several education paths aspiring nurse case managers can pursue. All nurse case managers must be licensed registered nurses and typically have completed at least a bachelor’s of science in nursing (BSN).

Aspiring nurse case managers can then choose to either complete a master’s of science in nursing with a case management specialization or complete a certificate program. The level of education required depends on certification pursued and employers’ requirements.

Admission requirements for nurse case manager programs vary based on the level of program completed. Master’s in nursing programs require applicants to hold an unencumbered registered nurse license and have completed a bachelor’s of science in nursing. Some master’s degree programs may require work experience, letters of recommendation, a current resume, and a statement of purpose.

Certificate programs, on the other hand, may have fewer admission requirements. More extended certificate programs may require a bachelor’s degree and an application, while mny shorter certificate courses are open to anyone.

It is essential that nurses attend an accredited nursing program. Accreditation assures the student, certification agencies, and employers that the program meets minimum quality standards in curriculum, facilities, and faculty. The two primary accreditation entities for nursing school are the Commission on Collegiate Nursing Education (CCNE) and the Accreditation Commission for Education in Nursing (ACEN).

If a nurse completes a nurse case manager certificate program that is not part of a nursing school, they should ensure that the program is from an institution that holds regional accreditation.

Samuel Merritt University

Samuel Merritt University offers an entry-level master of science in nursing in case management. This unique program is designed for students who already have a bachelor’s degree in a non-nursing field. However, applicants must be prepared for rigorous coursework and have extensive prerequisite coursework completed in nutrition, sociology, statistics, anatomy, and chemistry. The first four semesters of study are intensive, and students must be enrolled full time.

In the first semester in this program, students will be required to take a class in transitioning to a professional nursing career. Other required classes include community health nursing, analysis of health policy, advanced pathophysiology for nurse case managers, and others. Graduates will be prepared to sit for the NCLEX exam in order to become registered nurses.

• Location: Oakland, CA
• Duration: Two-and-a-half years
• Accreditation: Western Association of Schools and Colleges (WASC), Commission on Collegiate Nursing Education (CCNE)
• Tuition: $1,465 per credit

University of North Carolina at Pembroke

Nurses interested in providing case management to rural communities should consider the master’s of science in nursing rural case manager specialty concentration at the University of North Carolina at Pembroke. This two-year program prepares nurses for the unique challenges of providing case management care for clients in rural communities where there are often fewer resources.

Nurses will take classes in rural health care, advanced pathophysiology, epidemiology, global health, and financing health care. During their final semester, students will complete a capstone practicum and a research or action project. Admission requirements include a bachelor’s of science in nursing, a 3.0 undergraduate GPA, three letters of recommendation, a current resume, prerequisite coursework in statistics, and a personal statement.

• Location: Pembroke, NC
• Duration: Two years
• Accreditation: Southern Association of Colleges and Schools Commission on Colleges (SACSCOC), Commission on Collegiate Nursing Education (CCNE)
• Tuition: $2,042 per credit

Framingham State University

Framingham State University offers a three-course graduate certificate in nursing case management. Two of the courses are didactic, while the third is a practicum. Students will learn how to provide case management, coordinate care, and analyze health care practices to deliver quality patient care.

Graduates of this program are eligible to sit for the Certified Case Manager (CCM) exam offered by the Commission for Case Manager Certification (CCMC) or the Nursing Case Management Board Certification Exam (RN-BC) offered by the American Nurses Credentialing Center. Applicants to this certificate must already have a bachelor’s of science in nursing, hold a current nursing license, and submit a statement of purpose.

• Location: Framingham, MA
• Duration: Varies
• Accreditation: New England Commission of Higher Education (NECHE), Commission on Collegiate Nursing Education (CCNE)
• Tuition: $1,525 per course

University of Alabama – Capstone College of Nursing

The nursing case management certificate offered at the University of Alabama’s Capstone College of Nursing is designed for nurses who already hold a master’s degree. The focus of this program is to train nurses to work as case managers in rural populations. Nurses will learn how to utilize limited resources as well as work within rural health care systems to advocate for their patients and ensure continuity of care.

The program consists of 16 semester-credits in case management, epidemiology, and leadership. Students must also complete a practicum where they apply classroom concepts to actual patients. Applicants must already have a master’s in nursing from a regionally accredited institution, have a 3.0 graduate school GPA, and hold a current nursing license.

• Location: Tuscaloosa, AL
• Duration: One year
• Accreditation: Southern Association of Colleges and Schools Commission on Colleges (SACSCOC), Commission on Collegiate Nursing Education (CCNE)
• Tuition: $1,550 per credit

University of Utah – College of Nursing

Nurses who need additional education and training to become nurse case managers can complete the case management certificate at the University of Utah College of Nursing. Skills nurses learn include care coordination, care management, and case management.

Graduates will have the ability to help patients navigate a complicated health care system with ease. Required coursework includes legal issues in care management, health systems, and clinical issues. Students must also complete two practicums to gain hands-on experience working with patients.

• Location: Salt Lake, UT
• Duration: One year
• Accreditation: Commission on Collegiate Nursing Education (CCNE)
• Tuition: $7,707.13 to $8,801.77 per course

University of Missouri – Sinclair School of Nursing

The online interdisciplinary master’s of science in case management at the University of Missouri’ Sinclair School of Nursing is for both nursing and non-nursing professionals. Aspiring nurse case managers enrolled in this program will gain the necessary skills to provide high-quality, cost-effective care to clients who need help navigating complicated healthcare systems. This program places a strong emphasis on training case managers who can advocate for patients regardless of sexual orientation, race, military status, religion, or ethnicity.

Not only do students need to complete 33 semester-credits of coursework, but they must also complete 240 practicum hours, of which 180 must be direct case management. Candidates for admission must hold a healthcare-related bachelor’s degree, have a nursing license (if applicable), provide a statement of purpose, and submit a current resume.

• Location: Columbia, MO
• Duration: Two to three years
• Accreditation: Commission on Collegiate Nursing Education (CCNE)
• Tuition: $17,866 for the entire program

Upstate Medical University – College of Nursing

Busy nurses who want to move into case management can start their education with the three credit online nursing case management course at Upstate Medical University’s College of Nursing. This course is meant as an introduction to case management and provides students with a broad overview of the fundamentals.

Since this course is offered as a stand-alone class, nurses do not need to matriculate to attend. Students who have already completed a certificate or degree in case management can use this course as a certification exam review.

• Location: Syracuse, NY
• Duration: One semester
• Accreditation: Commission on Collegiate Nursing Education (CCNE)
• Tuition: $963 per credit

University of Southern Indiana – College of Nursing and Health Professions

The case management/care coordination program’s focus at the University of Southern Indiana’s College of Nursing and Health Profession is on care management practices, ethics, and standards.

This program is offered online, and assignments can be completed asynchronously, allowing professionals to further their education without quitting work or relocating. Students must score 70 percent or higher on the exams to successfully complete the program. Active nurse case managers can complete this program for continuing education credits or as a refresher before taking a certification exam.

• Location: Evansville, IN
• Duration: Eight weeks
• Accreditation: Commission on Collegiate Nursing Education (CCNE)
• Tuition: $600

University of Rochester – School of Nursing

Nurses and health care managers can obtain essential case management knowledge and skills with the online care management education program at the University of Rochester’s School of Nursing. This program is suitable for both active nurse case managers as well as aspiring ones. The 10 module program can be completed at the student’s own pace. Topics covered include collaborative care, planning transitions, population health, patient self-management, and professional development. At the end of each module, short quizzes evaluate students’ learning and must be completed to earn the certificate.

• Location: Rochester, NY
• Duration: Ten modules completed at the student’s own pace
• Accreditation: Commission on Collegiate Nursing Education (CCNE)
• Tuition: $495 for the entire course

The education and work experience requirements to become a nurse case manager take at least five years post-high school to complete.

Step 1: Graduate from High School or Complete a GED (Four Years)

The path to becoming a nurse case manager starts with graduating from high school or earning a GED. A diploma or GED is required to attend most nursing schools and demonstrates a minimum level of education. Aspiring nurse case managers should focus on biology, math, psychology, chemistry, and anatomy to help prepare them for further studies.

Step 2: Complete a Nursing Program (One to Four Years)

Aspiring nurse case managers must first earn a nursing degree. They can earn either an associate’s or bachelors’ in nursing. While accelerated associate-level programs can be completed in as little as a year, most take two years to complete. Bachelor’s degree programs take four years to complete. It should be noted that most nursing case managers have at least a bachelor’s degree.

Step 3: Pass State Required Test (Timelines Vary)

In order to become a registered nurse, candidates must pass a state licensing exam. Requirements can vary by state, so it is essential for aspiring nurses to contact their state’s board of nursing to ensure they take the correct exam and have the necessary credentials. Most states require candidates to pass the National Council Licensure Examination (NCLEX) offered by the National Council of State Boards of Nursing (NCSBN).

Step 4: Apply for State Licensure (Timelines Varies)

The final step to becoming a registered nurse is to apply for state licensure once education requirements have been met and candidates have passed the required exam.

Step 5: Obtain Case Management Work Experience (Timelines Vary)

All nurse case manager certification agencies require applicants to have completed some work experience. This experience is typically hands-on patient work providing case management services. Most nurses can earn this experience by volunteering for case management as part of their regular job duties.

Step 6: Complete Case Management Education (Optional, Timelines Vary)

While not required, education in case management can be beneficial to earn a high paying job in this field. Nurse case managers can complete a master’s in nursing in case management or complete a certificate program. These programs teach case management foundation and best practices. Most longer programs include a practicum requirement, providing students hands-on experience.

Step 7: Obtain Case Management Certificate (Optional, Timelines Vary)

Earning a certificate in case management is not required, although it can be beneficial. Certification demonstrates a high level of competency in the field and can help with employment opportunities or job advancement. Details about certifications nurse case managers can earn are found below.

Nurse case managers work in a variety of settings, including hospitals, insurance companies, public health agencies, hospice, home health centers, medical supply companies, and medical clinics. Job duties vary based on the place of employment. Typical day to day responsibilities can include:

• Meeting one-on-one with patients and their families to determine their health care needs
• Identifying clients current needs and connecting them to local resources including medical care, mental health therapy, housing, and more
• Advocating for patients’ needs with health care providers, insurance companies, and government agencies
• Scheduling patients’ appointments and ensuring they attend
• Following up with patients to ensure they are following a physician’s order or taking medications
• Educating patients and their families about their medical condition and acting as a resource when they have any questions.
• Monitoring treatments plans and patient progress to ensure care is effective
• Assisting patients with navigating the healthcare system
• Researching patient conditions and treatments to ensure patients are getting the best and newest treatments
• Maintaining careful client records
• Helping with insurance billing when necessary

There are three primary certifications nurse case managers can earn. The American Nurses Credentialing Center (ANCC) offers the Nursing Case Management certification, the Accredited Case Management credential is offered by the American Case Management Association (ACMA), and the Commission for Case Manager Certification (CCMC) offers the Certified Case Manager credential.

To earn an ANCC certification, candidates must:

• Hold a current unencumbered RN license
• Have two years of full-time work as a registered nurse
• Have a minimum of 2,000 hours of clinical practice in nursing case management within the last three years
• Complete 30 hours of continuing education in nursing case management within the last three years

Eligibility requirements for ACMA certification are:

• Hold a current unencumbered RN license
• Have at least one year, or 2,080 hours, of supervised, paid work experience employed as a case manager

The requirements to earn a CCMC certification are:

• Hold a current unencumbered RN license
• Have either 12 months of full-time case management, supervised by a CCM or 12 months of full-time case management employment experience as a supervisor of individuals who provides case management services or 24 months of full-time case management work experience

All nurse case managers must be licensed registered nurses in the state in which they practice. Requirements vary by state, so nurses should contact their local board to ensure they have the necessary credentials.

The Bureau of Labor Statistics (BLS May 2019) classifies nurse case managers as registered nurses. On average, registered nurses earn $77,460 per year. The percentiles for wages are:

• 10th percentile: $52,080
• 25th percentile: $60,110
• 50th percentile (median): $73,300
• 75th percentile: $90,760
• 90th percentile: $111,220

Social Worker

Social workers help adults, children, and other vulnerable populations who need support and assistance. Like nurse case managers, they can work in hospitals, although they are more frequently found in social service centers, government agencies, and mental health clinics. While they cannot diagnose and treat physical illnesses, clinical level social workers can diagnose and treat mental illnesses.

• Typical Education: Master’s degree
• Licensing or Certifying Organization: Association of Social Work Boards (ASWB)

Registered Nurse

Registered nurses coordinate and provide care for patients in a variety of medical settings. They have completed at least an associate’s degree in nursing, although most earn a bachelor’s of science in nursing. Most nurses work under the supervision of a physician.

• Typical Education: Associate degree or higher
• Licensing or Certifying Organization: State Board of Nursing National Council of State Boards of Nursing (NCSBN)

Nurse Administrator

Nurse administrators are registered nurses who are also members of a healthcare facility’s management team. Most earn at least a master’s degree in health administration or a related field. The most common role nurse administrators fill is that of supervising nursing staff in a particular department.

• Typical Education: Most earn at least a master’s degree
• Licensing or Certifying Organization: American Nurses Credentialing Center (ANCC) and the American Organization of Nurse Executives (AONE)

Kimmy Gustafson

Writer

At HealthcareDegree.com, Kimmy Gustafson has delivered in-depth and insightful articles since 2019, aiding prospective students to navigate the complexities of choosing the right healthcare degree. Her recent work includes topics such as the ethics of gene editing and physician assistant’s fight for autonomy.

Kimmy has been a freelance writer for more than a decade, writing hundreds of articles on a wide variety of topics such as startups, nonprofits, healthcare, kiteboarding, the outdoors, and higher education. She is passionate about seeing the world and has traveled to over 27 countries. She holds a bachelor’s degree in journalism from the University of Oregon. When not working, she can be found outdoors, parenting, kiteboarding, or cooking.