The role of a care manager has grown in importance in recent years as more Americans live with chronic illnesses, such as heart disease, cancer and diabetes, and as related health care costs continue to rise. According to the Centers for Disease Control and Prevention (CDC), 6 in 10 adults in the United States have a chronic disease and 4 in 10 have two or more. Today, the care of chronic disease is responsible for more than 85% of health care costs.
Patients need professionals to manage their care and help them navigate health care systems toward healthier outcomes. As a result, the care manager job description includes responsibility for increasing the efficiency of the facility’s medical services and patient care. Success as a care manager starts with the right educational background, which often begins with a Bachelor of Science in Nursing.
What Is a Care Manager?
Care managers advocate for patients from every angle, from navigating their home environment through assessing their health care coverage and billing. While it’s part of the care manager’s role to coordinate patient care, they work with other health care professionals to determine patients’ goals and create both short- and long-term plans to achieve those goals.
Care managers are primarily focused on overseeing and improving patient care and health outcomes. Based on their work experience in nursing and knowledge of organizational and health care systems, these professionals also aim to reduce preventable emergency room visits and hospitalizations.
Care managers provide patients with a coordinated, team-based approach to patient care, according to the Agency for Healthcare Research and Quality, which is a departure from the traditional disease-focused, provider-centric approach to health care.
Care Manager Job Description
Several key responsibilities are part of the care manager job description.
- Patient advocate. The primary focus for a care manager is to advocate for the care recipient and the family caregiver. This involves also overseeing and directing care provided at home.
- Comprehensive care manager. An integral part of the care manager job description is creating a comprehensive and individualized care plan to share with the patient and family members or other caregivers. This is done by assessing the level and type of care that’s needed.
- Policies and regulations proponent. Health care policies and regulations set expectations. Using current policies and regulations to guide care decisions aids in promoting consistency, reducing mistakes and improving safety for patients and staff.
- Health information technology facilitator. To promote successful health outcomes, care managers must manage patient records and work with patients’ providers using health information technology. Care managers also help patients with Medicaid qualification and application and assist with monitoring medications.
- Comprehensive transitional care manager. Care managers work to prevent avoidable readmissions and ensure that patients receive proper and timely follow-up care. Managers may provide assistance with placing a patient in an assisted living facility or nursing home or monitor the care of a family member there.
- Care coordinator. Because they serve as liaisons, care managers coordinate, monitor and reevaluate patients and their care. This includes monitoring medical appointments and medical information and coordinating with managers from different departments. As part of this effort, care managers conduct ongoing assessments and implement changes in care.
- Staff member trainer. Successful care managers ensure that other staff members offer all patients the same high level of care to achieve consistent outcomes for their patients and organizations.
- Community and social support referral provider. It’s important for care managers to be well-connected in their communities and within their own health care facilities. This allows them to offer referrals to patients that align with their individual care plans while taking into account any cultural or social support needs they have.
- Empathy provider and negotiator. Care managers are often tasked with taking on the role of helping to resolve family conflicts and issues relating to long-term care. Additionally, they can arrange for the services of legal and financial advisers.
Types of Care Managers
Students interested in becoming care managers can earn a bachelor’s degree in nursing, public health, health administration or business administration to pursue a variety of care manager positions. The role of the care manager varies depending on the setting and can include hospital care managers, home health care managers and health insurance care managers.
Hospital care managers typically meet with patients when they arrive or during their stay to determine the best possible treatment for both short- and long-term illnesses, according to ThinkHealth. They work with patients who’ve had major medical procedures, such as complex surgeries, to assist with transitioning safely out of the hospital.
Home health care managers support patients with multiple check-ins to monitor medical conditions and transportation challenges, poor living conditions and the lack of a support system, among other issues, per ThinkHealth.
On-site for companies, care managers are focused on improving employee health to boost productivity. According to the CDC, work-related injuries and illnesses, chronic diseases, absenteeism and sick employees who return to work before they are well cost U.S. employers billions of dollars each year.
Skills of Care Managers
Care managers must possess both broad and specific skills to serve in a variety of health care settings.
Some must-have skills for care managers include:
- Care managers hire, train, motivate and lead. They are often required to devise creative ways to remedy staffing or other administrative problems and communicate policies and procedures.
- Successful care managers garner the trust of their staff, colleagues, patients and organizations.
- Analytical skills. Care managers must regularly assess patients, their care plans and their life situations and make changes as needed. They also need to maintain a thorough and updated knowledge of current regulations and adapt to new legislation.
- Attention to detail. Among other tasks that require their close attention, care managers may be tasked with organizing and maintaining scheduling and billing information for large health care facilities.
- Technical skills. Care managers must maintain a working knowledge of health care technology and data analytics, such as coding and classification software and electronic health records systems.
- Interpersonal skills. A core part of the care manager’s job is forming relationships with patients and their families. Because the care manager job description is broad, they also often discuss patient information or staffing problems with physicians and health insurance representatives.
Salaries of Care Managers
According to the BLS, which classifies them as medical and health services managers, care managers had a median annual salary of $100,980 in May 2019. The highest 10% of care managers earned more than $189,000.
Salaries for this position vary depending on where these professionals work. Care managers working in government roles had an annual median salary of $111,520, followed closely by those who worked in hospitals (state, local, private) with $110,430. Care managers employed by outpatient care centers had an annual median salary of $96,320.
The projected job outlook for care managers is promising as Americans age and as medical technologies improve, according to the BLS, which predicts the number of jobs will grow by 18% between 2018 and 2028. More care managers are needed to organize and manage medical information and health care staff. Specifically, increased demand is projected for nursing care facility administrators as the population grows older.
Most care managers work full time. Some care managers who work in health care settings such as hospitals and nursing homes may be required to work evenings and weekends.
Take the First Step Toward a Career as a Care Manager
Embarking on a career in care management requires the skills to oversee and improve patient care and health outcomes. Those interested should look into the online Bachelor of Science in Nursing program at Rider University, which provides students with instruction in such courses as health care policy, population health, patient care technology, professionalism, cultural diversity and information management. Learn more about what Rider University can offer and jump-start your new career today.
ACR Open Rheumatology, “The Relation of the Chronic Disease Epidemic to the Health Care Crisis”
Agency for Healthcare Research and Quality, “Care Management: Implications for Medical Practice, Health Policy, and Health Services Research”
Centers for Disease Control and Prevention, About Chronic Diseases
National Care Planning Council, “About What a Care Manager Does”
ThinkHealth, “What Is a Care Manager?”
U.S. Bureau of Labor Statistics, Medical and Health Services Managers