Manage Care Nurses

Topics: Health care, Health care provider, Medicine Pages: 3 (485 words) Published: February 24, 2013
Managed Care Nursing

Managed Care Nursing
Andrea Mitchell
December 24, 2012
Jennifer Culotta

Managed Care Nurses
The managed care nurse is required to function in different types of settings and roles than the traditional nurse. The traditional nurse role is to provide patient care at the bedside. The role of the managed care nurse is to advocate for all patients, provide customer service, and administer benefits to all patients in the healthcare system.

How to become a Managed Care Nurse
To become a managed care nurse, one must attend and graduate from an approved nursing education program. It is helpful to take a few courses in social services because most managed care nurses work with patients that use social services to help for their health care. After completing their schooling and passing their National Council Licensure Examine, most nurses work as a floor or staff nurse in a clinic or hospital before entering managed care. This give them experience with patient assessment and care.

What Does a Manged Care Nurse Do
Managed care nurses develop and implement disease management programs, quality and demand programs, and wellness and preventions programs. This helps the managed care nurse to be proactive involving the patient to manage their health care needs. Managed care nurses maintain contact with the same patients building a strong patient-nurse relationship. Acting as a liaison between the patient and the health care organization that provides insurance coverage to make sure that the patient has access to the medical test, procedures, and medicines needed. Building relationships with the patients helps the nurse to monitor follow up physician visits and other necessary screening test. Managed care nurses are specifically trained in evaluating individual healthcare needs of patients and connect them to the most cost effective heatlh care...

References: Fritzgerald, M.L., & Crismon, C. (2001, August). Nursing in Manged care roles. Texas Nursing, 75(7), 11-13.
Jackson, S.E. (2006, February). The influence of managed care on U.S. baccalaureate nursing education programs. Journal of Nursing Education, 45(2), 67-74.
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