How to Become a Managed Care Nurse

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How to Become a Managed Care Nurse: Career Path Guide

If you want to become a managed care nurse, you first need to determine if this career path is a good fit for your skills, interests and personality traits. If the following description sounds like you, then you’re probably well suited for a career as a managed care nurse:

 

• You have a good understanding of health care economics

• You are interested in helping keep health care costs down for those without strong insurance plans

• You have an interest in working in a patient-facing nursing capacity

• You are able to balance quality care with cost effectiveness

• You are able to develop, implement and manage clinical programs

• You would enjoy acting as a liaison between different groups, such as doctors, patients, health care providers, etc.

 

Below we've outlined what you'll need to begin a career as a managed care nurse. We've also included helpful information for this career, such as job description, job duties, salary expectations, a list of possible employers and much more!

 

 

Education Needed to Become a Managed Care Nurse

Nursing is a regulated profession in both Canada and the United States. The educational requirements for becoming licensed as a nurse depend primarily on whether the nurse wants to become a Registered Nurse (RN) or a Licensed Practical Nurse (LPN).


 

Education Needed to Become a Registered Nurse (RN)

Canada: In Canada, you must first earn a Bachelor of Nursing degree before you can qualify for becoming a Registered Nurse.

 

United States: In the United States, you can qualify for becoming a Registered Nurse by earning a Nursing Diploma, an Associate of Science in Nursing (ASN) or a Bachelor of Science in Nursing (BSN).


 

Education Needed to Become a Licensed Practical Nurse (LPN)

Canada: To become a Licensed Practical Nurse in Canada (or Registered Practical Nurse - RPN in Ontario), you must be a graduate of an approved practical nursing education program, which is typically 2 years in duration, and includes a combination of classroom and laboratory instruction, and clinical experience in various health care settings.

 

United States: To become a Licensed Practical Nurse in the United States, you must complete an LPN training program, which may be offered at a technical school, vocational school or community college. These programs are typically 12 months in duration. 

 

 

 

Managed Care Nurse Job Description

Managed Care Nurses work with patients who primarily rely on government-funded healthcare within largely privatized healthcare systems. They often work with those who rely on programs like Medicare or Medicaid.

 

They work to keep the patient’s medical costs down by helping patients practice preventative care, and encouraging regular check-ups and vaccinations for themselves and their families. Managed care nurses are ultimately responsible for ensuring that desired clinical outcomes can be achieved in a cost-effective manner that supports the client, the organization, and ultimately the delivery of health care to the patient. 

 

Managed care nurses often work directly with patients and their caregivers, and act as a liaison between the patient, the doctor, facility staff, the patient's insurance company, the managed care organization and relevant community agencies.

 

 

Managed Care Nurse Job Duties

• Communicate with patients and their family, with a focus on relieving anxiety

• Maintain comprehensive patient records

• Make ethical decisions related to confidentiality and consent

• Act as a patient advocate

• Teach patients how to practice preventative care

• Work with diverse group of patients

• Organize staff and delegate work duties

• Perform setup for blood transfusions

• Write patient care plans

• Measure and analyze outcomes of care plan

• Administer medication and injections

• Observe and record the condition of the patient

• Respond to emergencies as necessary

 

 

 

Skills Needed to Become a Managed Care Nurse

In order to become effective in a career as a managed care nurse, and perform your job duties with competence, you need to posses a certain set of skills, including:

 

• Able to identify and gather information about community resources

• Knowledge of industry regulations and legislation

• Able to develop, implement and manage clinical programs

• Able to establish, implement and evaluate client-centered goals

• Basic knowledge of health care economics and health care management

• Good communication skills (for acting as a liaison between different groups, such as doctors, insurance companies, etc.)

 

 

Characteristics Needed to Become a Managed Care Nurse

In order to enjoy performing the duties of a managed care nurse, you need to have certain personality traits. Taking enjoyment from your duties as a managed care nurse is important, as it helps you maintain a positive attitude towards your work, which usually leads to having a long and successful career.

 

• You have tact, professionalism, empathy and patience

• You have an interest in helping keep health care costs low for vulnerable sectors of the population

• You have an interest in ensuring that people from vulnerable sectors of the population receive quality health care

• You have an interest in working in a patient-facing and managerial capacity

• You would enjoy acting as a liaison between different groups (including doctors, patients, health care providers, etc.)

 

 

 

Certification Needed to Become a Managed Care Nurse

To become licensed as a managed care nurse in Canada or the United States you must first be licensed as a Registered Nurse (RN) or a Licensed Practical Nurse (LPN). There is also a voluntary licensing credential available from the American Association of Managed Care Nurses: the Certification in Managed Care Nursing (CMCN) designation.

 

In addition to being licensed as an RN or an LPN, candidates must write an examination, passing which demonstrates they meet an acceptable minimum level of basic knowledge of the following components: Managed Care Overview, Health Care Economics, Health Care Management and Patient Issues. 

 

 

Managed Care Nurse Salary Level

The salary level of managed care nurses can vary, depending on their level of education, their level of experience, their level of responsibility, the size and type of their employer, the region in which they work, and many other factors.

 

Managed Care Nurse Salary Alberta: According to the 2013 Alberta Wage and Salary Survey, Albertans working in the Registered Nurses occupational group earn an average salary of $63,922 per year, and those working in the Licensed Practical Nurses occupational group earn an average salary of $45,170 per year.

 

Managed Care Nurse Salary Canada: According to Service Canada, the average salary of Canadian workers in the Licensed Practical Nurses occupational group earn an average salary of $35,538 per year, and those working in the Registered Nurses occupational group earn an average salary of $51,038 per year.

 

Managed Care Nurse Salary United States: According to the United States Bureau of Labor Statistics, the mean annual wage of American workers in the Nurse Practitioners occupational group is $95,070 per year, and those working in the Registered Nurses occupational group earn a mean annual wage of $68,910.

 

 

Who Creates Jobs for Managed Care Nurses?

Managed care nurses are employed on a part-time, full-time, or contractual basis (primarily in countries with privatized healthcare, such as the United States) by the following types of organizations:

 

• Hospitals and other health care facilities

• Health plan providers and vendors

• IRO/EQRO or accreditation organizations

• Managed care organizations

• Telephone triage centres

 

 

Managed Care Nurse Jobs

Our job board below has "Managed Care Nurse" postings in Canada, the United States, the United Kingdom and Australia.

Careers Similar to Managed Care Nurse

Listed below are careers in our database that are similar in nature to Managed Care Nurse, as they may involve many of the same skills, competencies and responsibilities.

 

Developmental Care Worker

Geriatric Care Manager

Licensed Practical Nurse (LPN)

Long Term Care Nurse

Registered Nurse

 

 

References: Managed Care Nurse Career Information

Please consult the references below to find more information on the various aspects of a career as a managed care nurse.

 

Alberta Learning and Information Service website: alis.alberta.ca

American Association of Managed Care Nurses website: www.aamcn.org

Johnson & Johnson - Discover Nursing website: www.discovernursing.com

United States Bureau of Labor Statistics website: www.bls.gov

 

 

Scholarships for Becoming a Managed Care Nurse

Scholarships in Canada and the United States listed for majors that apply to becoming a Managed Care Nurse can be found on our Nursing Scholarships page.

 

Success Tip: Be sure to apply for any scholarships that you even barely qualify for, as there are millions of dollars of scholarships that go unused every year due to a lack of applicants!

 

 

Becoming a Managed Care Nurse: Applicable Majors

Studying one of the university majors listed below is an excellent starting point to becoming a managed care nurse. Click on the links to find out what else you can do with these majors!

 

Nursing  

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