Nurse Case Manager: What They Do and How to Become One

Nurse case managers collaborate with patients to help them receive the treatment they need to meet their wellness goals.

As a liaison between health care professionals, providers, and patients, nurse case managers use the case management process to assess patient needs, devise treatment plans, schedule appointments, and ensure all relevant stakeholders are properly coordinated. 

For registered nurses (RNs) interested in employing their medical knowledge to help patients receive the care they need outside of the examination room, a career as a nurse case manager could be right for them.

In this article, you will learn more about what a nurse case manager is, what they do, and how to become one. You'll also learn what salary you can expect to earn, the job outlook for the field, and certificates and educational programs that can help you on the path to being a professional case manager. 

What is a nurse case manager?

A nurse case manager, or RN case manager, is a medical professional who works with patients and connects them with the health care professionals, providers, and resources they require to achieve their wellness goals.

As registered nurses (RN), nurse case managers use their medical expertise to ensure that patients have access to appropriate health services, while also setting appointments for them, creating appropriate treatment plans, and communicating with health insurers. 

What does a nurse case manager do?

A nurse case manager’s work is centered around providing their clients with the best possible health care that fits their personal circumstances. Common duties they perform include: 

• Evaluating a client’s medical history

• Interviewing clients and assessing their needs, health history, and existing support network

• Acting as a liaison between clients, health care providers, and health insurers

• Designing treatment plans and scheduling appointments

• Educating patients and their families on relevant health-related matters

• Keeping track of health outcomes and suggesting possible treatment changes

• Providing care for patients

Nurse case manager salary

Nurse case managers often earn a higher than average salary.

According to Glassdoor, the average total pay a nurse case manager earns is $93,412 a year, which consists of a base annual salary of $88,939 and additional compensation of $4,473 [1]. Furthermore, Glassdoor notes that the total pay nurse case managers can expect to earn changes with their experience level: 

• 0-1 year: $79,501 per year

• 1-3 years: $80,044 per year

• 4-6 years: $82,922 per year

• 7-9 years: $87,464 per year

• 10-14 years: $96,781 per year

• 15+ years: $103,899 per year

Job outlook 

Though there is no official data on the job outlook for nurse case managers, related data on both health care and nursing suggest that field is likely to be healthy in the coming decade.

According to the Bureau of Labor Statistics (BLS), the health care profession is expected to grow by 13 percent between 2021 and 2031 [2]. Over the same period, the BLS notes the number of nurses is expected to grow by 6 percent, adding an additional 203,200 jobs each year [3]. These figures combined with an aging population indicate that professionals in the field are likely to be needed for the foreseeable future. 

Work environment

RN case managers can work in a variety of health care settings, including hospitals, medical facilities, physician's offices, government agencies, outpatient facilities, and for insurance providers.

How to become a nurse case manager 

Nurse case managers are qualified medical professionals who pair expert knowledge with an astute understanding of the health care system. To join this impactful profession, you should do the following: 

1. Attend a nursing program. 

The first step to becoming a case manager is to become an RN, which requires attending an accredited nursing program.

There are three types of programs that teach the skills necessary to become an RN: non-degree nursing programs, an associate degree in nursing (ASN) program, or a bachelor of science in nursing (BSN) program. Each of these educational programs is designed to give you the skills and knowledge required to be a registered nurse, including medical knowledge and health care training. 

Nonetheless, some employers may prefer candidates who have bachelor’s degrees, which is becoming more common in the profession. The best program for you, though, is likely the one that fits your needs and professional aspirations. 

Read more: How to Get Into Nursing School: Your Guide to a Degree

2. Take the NCLEX-RN and become licensed.

Once you have completed your nursing program, you become eligible to take the NCLEX-RN, which you must pass in order to practice professionally. Administered by the National Council of State Boards of Nursing (NCSBN), the NCLEX-RN tests both your nursing knowledge and your ability to think critically through common nursing scenarios. After you have passed the NCLEX-RN, you must also receive your state licensure, which allows you to practice in the awarding state. 

3. Gain nurse case management experience.

After becoming an RN, you are technically qualified to become a nurse case manager. While in some cases you might find that you are able to find a case management position right away, you can also gain experience in entry-level nursing positions that include some case management elements.

In these positions, you would gain nursing experience while learning how medical facilities operate, the health care system is structured, and how case management nurses maneuver them to help clients. 

Whatever path you choose, gaining some years of experience as a nurse will likely only improve your chances of pivoting into a case management position later. 

4. Consider becoming certified.

One of the ways to signal your qualification as an RN case manager is to obtain a Professional Certificate. Some of the most common certifications include the following: 

The Accredited Case Management (ACM) Certification offered by the American Case Management Association (ACMA) demonstrates the certificate holder’s professional expertise in the field. To obtain it, you must be a licensed RN or social worker, have at least one year of case management experience and pass a two-part exam consisting of knowledge-based questions and clinical simulations. 

The Nursing Case Management Certification (CMGT-BC) offered by the American Nurses Credentialing Center demonstrates the certificate holder’s competency in the field.

In order to obtain the certificate, you must be a licensed RN who has practiced continuously for the past two years, has a minimum of 2,000 hours in clinical case management in the past three years, and has completed 30 hours of case management education in the past three years.

The exam to obtain the certificate consists of four sections: professional foundation, core coordination, quality management, and health promotion.

Read more: How to List Certifications on Your Resume: Guide + Examples

Learn more about health care with Coursera 

A good case manager knows as much about the health care system and patient care as they do about actual health. If you're considering a career in the field, then you might consider taking an online educational course to hone your skill set and reinforce your knowledge.

In The University of Houston’s Value-Based Care Specialization, you'll learn how to lead a culture of collaboration in the workplace focused on value-based care.