How to Decide Whether to Become a Case Manager

Imagine you’ve just been released from the hospital after a catastrophic illness. You’re out of danger but by no means well. You’ll still need to see the same specialists you were seeing as an inpatient. A visiting nurse will have to come once a day. Your doctor has recommended that you work with a physical therapist to speed your recovery. You have been prescribed multiple medications. And you don’t have friends or family nearby to support you as you recover.

All is not lost. You may be a prime candidate for a case manager, a professional who can take a hands-on approach to coordinating your post-discharge care. They will help you:

• Schedule appointments to ensure they don’t overlap
• Make sure your care plan is appropriate for your condition
• Help prevent dangerous interactions between medications
• Monitor your care plan as it evolves to make sure you’re not being under- or over-treated

A case manager in social work, substance abuse treatment, or another discipline may work with very different types of clients, but what they do for those clients is quite similar. In all fields, case managers keep their clients on track so they can meet their goals. It’s a great career for very organized and tenacious people who love seeing others succeed.

In this article about how to become a case manager, we’ll cover:

• What case managers do
• Where case managers work
• The difference between a social worker and a case manager
• Education required to become a case manager
• Licensing and certification requirements for case managers
• The skills and qualities case managers need to succeed
• How to decide whether to become a case manager

What case managers do

There is no such thing as a typical day in case management. Every client has a different story and different needs, and case managers can be found in a wide variety of settings. There are, however, five core functions of case management, and these can tell you a lot about what case managers do. They are:

• Assessment
• Treatment planning
• Linking
• Advocacy
• Monitoring

When you become a case manager, tasks related to these five functions will make up a large part of your responsibilities.

• Assessment involves speaking with clients, reviewing their case histories, and meeting with coworkers and other care providers.
• Treatment planning consists of developing treatment plans (depending on what field you’re in), helping a client follow a care plan developed by someone else (like a doctor or social worker), or handling discharge planning.
• Linking involves finding resources like health screenings, welfare programs, specialists, or addiction treatment programs and helping clients gain access to them. You might also help facilitate communication between a client and an employer, attorney, doctor, crisis center, counselor, or government agency.
• Advocacy involves speaking for clients who are unable to represent themselves or fighting for them when needed aid is denied.
• Monitoring is all about frequently checking in with clients and with the resources they’re using to make sure they are attending appointments, getting high-quality care, and meeting goals.

On top of all of this, case managers do a lot of paperwork. You’ll need to take notes consistently; not only do you need to be sure you’re giving each client the correct information, but you will usually also need to meet specific documentation and reporting requirements dictated by your employer. Case managers who are employed by government agencies, licensed by the state, or funded by grants usually have to follow the most stringent documentation rules, but all case managers take tons of notes each day as part of keeping case records up-to-date.

Where case managers work

When people hear the words ‘case manager,’ they usually think of social work. However, case managers come from different backgrounds (e.g., nursing, medicine, substance abuse counseling, rehabilitation counseling) and work just about everywhere you find people who need help. When you become a case manager, you might work in a:

• Doctor’s office
• Acute care facility
• Hospital
• Rehabilitation center
• Nursing home
• Insurance company
• Social services agency
• School system
• Child welfare agency
• Hospice facility
• Palliative care center
• Addiction treatment facility
• Law firm
• Veterans’ support organization

In each of these settings, case managers:

• Assess the strengths and weaknesses of clients
• Find appropriate resources
• Investigate and work to overcome barriers to care
• Support clients as they pursue wellness, financial, educational, rehabilitation, or employment goals

How they do these things depends on where they work. Some examples:

• Hospital case managers are often trained nurses who have the knowledge necessary to review inpatient care plans and oversee discharge planning. Their job is to look at patients’ ongoing medical needs to make sure they can access medically necessary treatments in the right setting (hospital or home). They also review each patient’s insurance plan and work closely with the insurance provider to make sure that most or all treatments and medications will be covered.
• Home healthcare case managers have responsibilities similar to hospital case managers but work on behalf of patients who receive care at home. They work closely with caregivers, insurance companies, patients’ doctors, visiting nurses, and aides to develop and implement care plans.
• Nurse case managers usually work with patients who need long-term care in a hospital or institutional setting. They often work with specific populations (e.g., cancer patients, the elderly, people with brain injuries). Because they are typically registered nurses, they have in-depth knowledge of what types of care and services their patients will need to have the best possible quality of life.
• Health insurance case managers work with hospital case managers, doctors’ offices, specialists, and patients to make sure those patients are getting the correct care in the proper setting and that their care is being delivered economically. Unlike most other case managers, health insurance case managers won’t always be able to put the needs of their clients first, because they answer to the insurance company.
• Child case managers work exclusively with clients under the age of 18 and, in some cases, their families. They often work for family services agencies with children who have been neglected or abused, but can also be found in hospitals and clinics, where they work on behalf of kids with physical, mental, or behavioral issues.
• Correctional case managers work with people who will be serving, are currently serving, or have served time in prison. Their job is to help those people make the most of the rehabilitative services offered at a facility and to help make their release back into the community as smooth as possible. They do this by connecting them to social programs and employment opportunities and following up frequently with probation officers and parole officials.

The difference between a social worker and a case manager

There’s a lot of overlap in what case managers and social workers do. Both provide direct support to clients, help clients access outside resources, and monitor them as they work to meet their goals. However, there are some notable differences when it comes to the qualifications necessary to enter these professions and how the professionals in them serve their clients.

Social workers must be licensed to practice; some even have the qualifications required to provide therapy and other clinical mental health services. Clinical social workers must hold a master’s degree or doctorate, and there are specialty certifications in just about every area of social work. Most case managers outside of social work settings, on the other hand, do not need to be licensed or certified. They also don’t officially provide any direct support services to their clients. Their role is one of care coordination.

Education required to become a case manager

The educational commitment required to become a case manager is tough to pin down because, as the Case Management Body of Knowledge puts it, “Case management is not a profession unto itself. Rather, it is a cross-disciplinary and interdependent specialty practice.”

Employers typically require case managers to have a bachelor’s degree, though, in some settings, case managers might receive in-depth on-the-job training after earning an associate’s degree. A nurse case manager will have at least an associate’s degree in nursing or a bachelor’s degree in nursing. A mental health case manager might have a bachelor’s degree in psychology, while a social work case manager might have a bachelor’s degree in social work. That said, there are some settings (often nursing homes and home health agencies) where case managers are likely to have master’s degrees.

If you think you might want to become a case manager but you’re not sure of they setting you want to work in, your best bet is to earn a bachelor’s degree in social work, psychology, human services, sociology, nursing, counseling, healthcare administration, or criminal justice. You won’t learn to be a case manager in these programs, but you will learn a lot about the kinds of help struggling people need. You can round out your education with one or more internships in a medical facility, social services agency, or another setting where case managers work.

Licensing and certification requirements for case managers

Licensing and certification requirements for case managers vary by discipline and by state. Caseworkers who have the most direct contact with clients (like social work case managers and nurse case managers) are most likely to need a license to work. Legal case managers and medical case managers may not require any license or credentials at all outside of a degree to find employment, though they may choose to pursue voluntary certifications.

General certification for case managers is handled by a variety of professional organizations. One is the Commission for Case Manager Certification, which offers the only cross-discipline Certified Case Manager (CCM) credential. There are also discipline-specific and clinical case manager certifications. Social work case managers can earn the Certified Social Work Case Manager (C-SWCM) credential. Medical case managers can earn the Accredited Case Manager credential. For nurses, there’s the Nursing Case Management Board Certification.

Most general and discipline-specific certification programs for case managers require applicants to have at least a bachelor’s degree and a specified minimum number of hours of supervised or independent work experience.

The skills and qualities case managers need to succeed

As a case manager, you’ll need more than just empathy. You’ll deal with clients who are struggling yet may actively reject your help. Caseloads can be overwhelming. You may handle 20 to 50 cases regularly or more than 100. To succeed in this oftentimes-stressful role, you need to be:

• A great communicator
• Highly organized
• Good at remembering minor details
• An excellent problem solver
• Empathetic
• Culturally sensitive
• Able to read non-verbal communication
• Rational and non-reactive (some clients may lash out)
• Trustworthy
• A skilled educator
• A strong negotiator
• Willing to advocate
• Able to meet deadlines
• A team player
• Calm under pressure
• Respectful of diversity
• Patient

You also need to be motivated by a strong desire to help others. This is a profession where it’s all too easy to succumb to burnout. Caseloads can spike without warning. You’ll be dealing with tons of red tape. There will be days when you will have to argue, beg, and cajole to get your clients what they need. Some of the people who need your help the most won’t want to take it. And if you’re working with the neediest or most traumatized populations, you may find it hard not to take your work home with you in the form of anxiety, guilt, or depression. Focusing on the good you’re doing in the world can make it easier to cope when the going gets tough. Not everyone can find that balance.

How to decide whether to become a case manager

There are pros and cons to becoming a case manager. The biggest cons are probably stress, coupled with low pay (in most disciplines). As a nursing case manager, you’ll make about $61,000 a year, but most other case managers make closer to $45,000 annually. You may be able to earn more by earning certifications or a relevant master’s degree. There are no guarantees, though, and earning more money may not be enough to counteract the effects of a very heavy caseload.

There are plenty of pros to balance out the cons, however. In this role, you can make a real difference in someone’s life. Watching your clients get closer and closer to reaching their goals can be incredibly rewarding. You’ll be able to choose from a variety of settings or specialize in one service area; case management offers lots of choices. And chances are there will be plenty of jobs in case management going forward. Case management isn’t for everyone, but if you have the endurance and the dedication it takes (plus a great memory and a high tolerance for paperwork), it may be for you.

Questions or feedback? Email editor@noodle.com