3 Emerging Roles for Registered Nurses

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Nurse and patientThe increased focus on prevention and cost containment in health care offers new roles and opportunities for registered nurses. Many of these new functions are away from the bedside and focus more on coordination between health care providers and patient education. Here’s an overview of three of these emerging job titles; nurse case manager, nurse navigator and RN health coach.

What does a nurse case manager do?

Nurses who are case managers coordinate long-term care for patients with catastrophic injuries and chronic illnesses. These may include conditions such as spinal cord injuries, amputations, traumatic brain injuries, cancer, HIV/AIDS, diabetes, COPD and end-of-life issues. They are also known as care managers or care coordinators.

Case management nurses must be registered nurses, and many have a bachelor’s or advanced nursing degrees. It’s important the case manager have a strong clinical background to understand the medical and psychological issues that accompany illness and injuries.

According to the Case Management Society of America (CMSA), case managers help patients better understand their diagnosis and what they can do about it while also providing cohesion with other professionals in the health care delivery team. Case managers review patient charts, coordinate care with doctors and social workers for care after hospitalization and need to be experts in insurance coverage and reimbursement. Effective case managers need to have excellent problem-solving and organizational skills, as well as the ability to build relationships with community partners.

Nurse case managers usually work with a certain age group, such as children or seniors, or specialize in a specific disease or condition so they can better stay current on the latest procedures and treatments. They typically work in hospitals, rehabilitation clinics, insurance companies or as independent consultants.

Becoming a nurse case manager

While not required, hospitals and insurance companies prefer to hire nurse case managers who are certified. The Commission for Case Manager Certification, the American Case Management Association and the American Nurses Association are a few of the organizations that offer certification.

Salaries for nurse case managers range from $64,879 (Payscale.com) to $72,075 (Salary.com).

The employment outlook for case managers looks promising. As more managed care organizations look to streamline costs, the demand for case managers will continue to increase.

What does a nurse navigator do?

Nurse navigators (also known as patient advocates) help patients find their way through the complicated health care system. They may be hired by patients directly or work in community clinics, oncology and other specialty clinics and hospitals.

Linda Adler, owner of Pathfinders Medical Advocacy & Consulting, says the difference between nurse navigators and case managers is nurse navigators ensure that “the patient is at the center of the entire disease process.” These professionals are often by a patient’s side during treatment and are concerned with making sure the patient feels fully informed and prepared.

Nurse navigators can help patients get prescriptions, file insurance claims and arrange transportation to medical appointments. In addition, they may assist patients in developing, interpreting and following health care plans. Some navigators work only with older adults, others only with cancer patients or others only to solve medical billing problems.

Becoming a nurse navigator

Elisabeth Schuler Russell, president of the National Association of Healthcare Advocacy Consultants says many people who do this type of work have been through a life-changing event, either themselves or with a family member, and have learned how difficult it is to manage a serious disease in today’s health care system.

The demand for nurse navigators increased significantly after the Patient Navigator Outreach and Chronic Disease Prevention Act of 2005 passed. This law authorized more nurse navigators to be hired in community health centers.

Average salaries for nurse navigators range from $57,000 (Simply Hired) to $64,992 (CareerBuilder).

What does an RN health coach do?

An RN health coach (also known as a wellness coach or chronic illness coach) motivates and educates patients to engage in healthier behaviors in order to better manage chronic conditions, such as diabetes or heart disease, or to improve their overall well-being.

Coaches may work independently or within a hospital, clinic or health insurance company. For example, diabetes treatment centers such as American Healthways hires coaches to work as part of a multidisciplinary team, and insurance plans such as Aetna, Cigna, Health Net and Blue Shield hire nurses to work as health coaches over the phone.

RN health coaches help clients define and achieve goals through evidence-based behavioral change techniques. They educate their clients, motivate them to change their behavior and involve families and caregivers when necessary. In addition to being an experienced RN, health coaches need to know about different cultures, family dynamics and motivational techniques.

Becoming an RN health coach

RN Health Coach Judith Beaulieu says in an interview on JobShadow.com many physicians refer patients diagnosed with chronic conditions to a health coach. According to Beaulieu, an independent RN Health Coach averages between $75 to $125 an hour, and some earn up to $200 an hour. A survey of salaries online found a range of $61,000 annually on Simply Hired to $80,264 on Career Builder for full-time positions.

Certification, while not mandatory, is available through the American Holistic Nurses Credentialing Corporation and the International Nurse Coach Association.

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