Does a Case Manager Need to Be an RN?

If you are searching for jobs online and see postings for Case Manager job opening, then it might occur to you to wonder if you need to be a Registered Nurse to apply for the job.

The quick answer is no. A case manager does not need to be a RN. Sometimes a company will require that a case manager have a RN license, but that is not always the case.

There are many case manager roles that do not require a RN degree. Some case manager roles are more fitting for someone who studied Social Work or another field unrelated to Nursing.

In fact, most case managers are not RNs and do not function in a medical capacity. The job of a case manager more often than not is to handle paperwork, client support networking, benefits assistance, and other issues that are not in the job scope or training of a nurse.

In order to make it clearer, let us step through some questions that will uncover what the actually difference is between a regular case manager and a  RN case manager and then you’ll see that case managers do not need to be nurses.

What Type of Case Manager Role Is It?

The first thing that you should review is the job details. These are found on job posting sites under the job description section. This should specific if a RN is required for the role.

In fact, even before you get to the job detail section, you should see the words RN or Registered Nurse in the title. It’s to the benefit of the company posting the ad to make it clear that they are only interested in hiring a Nurse.

Some job platforms charge companies ever time someone clicks on an add, so if a company needs to hire a Nurse and they do not want to waste their budget on people who are not qualified.

If the job posting is for a case manager, then odds are that you do not need to be an RN. In most cases, the only requirement to work as a case manager is to have a bachelors degree and have some experience working with a benefits program.

There are situations where a nurse is required to work as a case manager, but these jobs will be very clearly labeled RN. The RN case management jobs are specific to situations where a licensed and registered nurse is required. This is always due to insurance purposes.

Companies who hire nurses, be it a hospital or a non-profit, do so because they are being reimbursed by Medicaid or another insurance program. The nurse is reviewing medical matters and the law requires that a medical professional handle this.

RN Case Managers vs Social Service Case Managers

RN Case managers handle medical issues and review medical paperwork. They might be tasked with checking the medical chart of a person who is on disability and receiving government supportive housing.

Other RN case managers are responsible for calling and scheduling doctor appointments for people who are in medically managed care. For instance, a person who is in a MICA population and suffers from multiple drug and mental health issues, might be under a Nurse case managers charge.

That nurse would then be responsible for making sure that the client was contacted by a taxi service and driven to their doctor appointment. The nurse would then review the doctors results and make sure that the pharmacy provides the correct medication.

Often times the RN case manager would then collaborate with the social service case manager and help them obtain paperwork which would continue to allow the client to review supportive housing and funds to secure food (EBT) and other daily living expenses which they would otherwise be in need of.

Do Some Case Manager Roles Require an RN Degree?

Yes, some case manager roles certainly require an RN degree. These are jobs that are involved in medical review and medical care. Non-profits, government agencies and other state and city funded agencies will very often be responsible for medical care of people.

The client base of these groups includes people who are in Medicaid or are otherwise in the care of the government. For example:

• Children in foster care
• Elderly and Infirm people who are destitute
• Mentally Ill Individuals
• Chronically Unemployed
• Families in Low Income Housing
• Veterans
• HIV/AIDS
• Single Parents Unable To Work

All of the above are populations where there will be a need for a nurse case manager. The government funded agencies that are in charge of the health and welfare of these populations all use trained nurses to review their medical needs.

This might be as simple as a nurse checking the blood pressure of someone to make sure that they are hypertensive and can receive disability payments and continue to qualify for government funded housing, or it might be more involved and include a nurse reviewing the medical paperwork of a homeless MICA client who is suffering from comorbidities including HIV.

While someone without a RN might believe that they could also do these jobs (review paperwork and call people to schedule doctors appointments) the fact is that because the agencies are being reimbursed with Medicaid or through another government funded agency, they require due to legal protocols, a trained and licensed nurse.

Many nurses in fact work multiple jobs, including a side hustle. These side hustles might be a hospital Per Diem, or more commonly, a per diem case management role doing assesment or some other sort of client intake. The requirement for these roles, however, will always be that the applicant has an RN degree.

Most of the RN case manger jobs will be found through temp agencies. Hospitals, for instance, often have the need for a RN case manager, but they will not hire these nurses direclty. The reason has to do with insurance, behefits, and union contracts. So, RN’s looking for Per Diem case manager roles are advised to use agenceis.