“I continue to sing the praises of case managers in every care setting as they are such a critical component of care delivery, connecting patients and families with the right resources and understanding all the care needs of each individual patient.”
Renee McInnes, MBA, CEO of NVNA and Hospice
Navigating the medical system can be daunting for even the most basic healthcare needs. 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 receive adequate care.
Nurse case managers are registered nurses with 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 have completed additional education and certifications to demonstrate their proficiency in this field.
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.
Meet the Expert: Renee McInnes, MBA, RN
Renee McInnes has been the CEO of NVNA and Hospice since 2016, where she leads a dedicated team of over 300 employees, providing essential home healthcare and hospice services across 27 communities on the South Shore. Under her leadership, the organization has achieved remarkable success, including over 120,000 patient visits in 2023 and consistently high patient satisfaction scores.
McInnes has spearheaded a philanthropy program that has raised over $20 million for patient care. Recently appointed as chair of the Home Care Alliance of Massachusetts Board of Directors, she advocates for improved access to care and community health advancement. Before this role, she was a nurse case manager at Tufts Medical Center. She holds an MBA in healthcare administration from Fitchburg State University.
HealthcareDegree.com: What is something you wish the public understood about nurse case managers?
McInnes: Case managers are the navigators for patients and families in many care settings. In hospitals, they hold the keys to a safe and agreed-upon discharge plan. Case managers are very knowledgeable about all post-acute care settings and what level of care is appropriate for the patient. They are also responsible for understanding the Insurance authorizations that are required for each setting.
The case manager’s role in home health and hospice also encompasses working with patients, families, or caregivers. The nurse is highly skilled in home health or hospice care but is also the navigator for all their care needs. For example, the nurse communicates with the physicians and other clinicians treating the patient in the home. The case manager is always focused on excellent care and quality outcomes along with the safety and comfort of the patient. They are the teacher, coach, listener, and trusted advisor.
I continue to sing the praises of case managers in every care setting as they are such a critical component of care delivery, connecting patients and families with the right resources understanding all the care needs of each individual patient.
HealthcareDegree.com: What advice would you give to aspiring nurse case management students?
McInnes: What I would tell nursing students is that the case manager is a highly respected and critical role. You get to really understand the patient holistically, including evaluating social determinants of health. You are caring for the patient and family holistically, not in a silo.
You will learn about all the care setting options and resources for patients and families in the community. You will learn so much by doing medical rounds in the hospital with the team and putting the pieces of the puzzle together for a safe and agreed-upon discharge plan. You will gain knowledge of how insurance plays a role in their care and how to navigate the advocacy needed to support them. Every patient and family is unique and different, and you will learn to meet them where they are and educate them about their options.
Nurse Case Manager Specializations & Degree Types
Aspiring nurse case managers can pursue several education paths. 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 complete a master’s of science in nursing with a case management specialization or a certificate program. The level of education required depends on the certification pursued and employers’ requirements.
Admissions Requirements for Nurse Case Manager Programs
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 many shorter certificate courses are open to anyone.
Nurse Case Manager Program Accreditation
Nurses must attend an accredited nursing program. Accreditation assures students, certification agencies, and employers that the program meets minimum quality standards in curriculum, facilities, and faculty. The two primary accreditation entities for nursing schools 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 outside of a nursing school, they should ensure that the program is from an institution that holds regional accreditation.
On-Campus Nurse Case Manager Degree Programs
Samuel Merritt University offers an entry-level master of science in nursing in case management. This unique program is designed for students with 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 of this program, students will be required to take a class on 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 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)
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 with often fewer resources.
Nurses will take classes in rural healthcare, advanced pathophysiology, epidemiology, global health, and financing healthcare. Students will complete a capstone practicum and a research or action project during their final semester. 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)
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 healthcare 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)
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 be able to help patients navigate a complicated healthcare 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)
Online or Hybrid Nurse Case Manager Degree Programs
Post University – American Sentinel College of Nursing & Health Science
The master’s of science in nursing (MSN) with a case management specialization at Post University is designed to enhance patient care outcomes through personalized services and patient advocacy. The program, accredited by the Commission on Collegiate Nursing Education, focuses on patient referrals, care planning and delivery, and evaluation of patient results. It offers flexible online classes, requiring 36 credit hours over 16 to 24 months, with monthly start dates. Students can choose between a term-based or self-paced SIM Path format. The program is built on the Case Management Society of America’s core curriculum standards.
- Location: Waterbury, CT
- Duration: 16 to 24 months
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
The care coordinator certificate at Nebraska Methodist College is a post-master’s program designed to enhance the skills of nurses in care coordination and patient navigation. This online program, which can be completed in 12-16 months, requires 14 credit hours. It prepares nurses to improve health outcomes for individuals with chronic diseases by acting as a bridge between public health, population health, and healthcare systems. The curriculum includes courses on healthcare systems management, care coordination processes, and a practicum for practical application. Graduates may be eligible for the Care Coordination and Transition Management certification exam.
- Location: Omaha, NE
- Duration: Six semesters
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
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 introduces case management and gives students a broad overview of the fundamentals.
Since this course is 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)
University of Southern Indiana – College of Nursing and Health Professions
The case management/care coordination program focuses on care management practices, ethics, and standards at the University of Southern Indiana’s College of Nursing and Health Professions.
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 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)
University of Rochester – School of Nursing
Nurses and healthcare 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 and 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)
How Long Does it Take to Become a Nurse Case Manager?
The education and work experience requirements to become a nurse case manager take at least five years post-high school to complete.
How To Become a Nurse Case Manager – Step-by-Step Guide
Step 1: Graduate from High School or Complete a GED (Four Years)
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. 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)
To become a registered nurse, candidates must pass a state licensing exam. Requirements can vary by state, so aspiring nurses must 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 typically involves hands-on patient work that provides 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 for earning a high-paying job in this field. Nurse case managers can complete a master’s in nursing in case management or a certificate program. These programs teach case management foundations and best practices. Most longer programs include a practicum requirement, providing students with 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.
What Do Nurse Case Managers Do?
Nurse case managers work in various settings, including hospitals, insurance companies, public health agencies, hospices, 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 healthcare 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 healthcare 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 treatment 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
Nurse Case Manager Certifications & Licensure
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 where they practice. Requirements vary by state, so nurses should contact their local board to ensure they have the necessary credentials.
How Much Do Nurse Case Managers Make?
The Bureau of Labor Statistics (BLS May 2023) classifies nurse case managers as registered nurses. On average, registered nurses earn $94,480 per year. The percentiles for wages are:
- 10th percentile: $63,720
- 25th percentile: $75,990
- 50th percentile (median): $86,070
- 75th percentile: $104,670
- 90th percentile: $132,680
Nurse Case Manager Alternatives
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 various 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 and also members of a healthcare facility’s management team. Most earn a master’s degree in health administration or a related field. The most common role of nurse administrators is 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
WriterAt 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.