Nurse Case Manager: What the Role Involves and How to Get Into It

For patients with complex needs, the biggest problem is often not a lack of care, but care that doesn’t join up. Nurse case managers coordinate services, plan discharges and help people navigate the system, so nothing falls through the gaps.

Imagine an older man with heart failure, diabetes and early dementia who has been admitted to hospital five times this year. A nurse case manager meets him and his daughter, sorts out his medicines, arranges home support and a heart failure nurse, and checks in weekly. The admissions stop.

What case managers do

• Assess needs and create care plans with patients and families
• Coordinate services across hospitals, community, social care and insurers
• Plan safe discharges and reduce readmissions
• Advocate for patients and monitor progress

They work in hospitals, community teams, insurance companies, workers’ compensation, and some work remotely.

How to get into it

• Build broad clinical experience, often several years
• Develop strong communication, organisation and negotiation skills
• Learn how health and social care funding work in your country
• In the US, consider CCM (Certified Case Manager) or ANCC case management certification

But will I miss hands-on care?

Some nurses do. Case management involves more phone calls, meetings and documentation than bedside care. But it uses clinical judgement every day and can have a big impact on patients’ lives.

Sources: Case Management Society of America, Commission for Case Manager Certification, American Nurses Credentialing Center, World Health Organization (Integrated people-centred health services). This article is for general information.