Managed Care Nurse

What Does a Managed Care Nurse Do?

Managed care nurses are specially trained to evaluate the individual health care needs of patients, especially those using social services, and connect them to the most cost-effective health care providers who can meet those needs. They also educate patients on preventive health care and counsel them on getting regular check-ups and taking their children for regular check-ups and vaccinations. Managed care nurses emphasize prevention because they know that regular low-cost check-ups can head off higher medical costs later, especially if health problems are caught early. Managed care nurses need to have good communication skills and must be comfortable working with diverse populations. They often work with the elderly and the poor, many of which rely on the government for their health care through Medicare or Medicaid. Managed care nurses often act as a liaison between the patient, their insurance company, and the health care provider, and play a role in making sure a patient is not receiving unnecessary medical treatments and that they have consistent access to quality medical care.

How Can I Become a Managed Care Nurse?

The first step toward becoming a managed care nurse is to complete an approved nursing education program. The most common way of doing this is to earn a degree in nursing. Most nurses have earned either an Associate of Science in Nursing (ASN) or a Bachelor of Science in Nursing (BSN) from an accredited college or university. Less common is earning a nursing diploma, a program typically offered through hospitals. During your nursing education, it is helpful to take elective courses in social work, as most managed care nurses work with populations who are using social services to pay for their health care. After completing a nursing program, all future nurses go on to take an exam called the NCLEX (National Council Licensure Examination) so they can become licensed to practice nursing in their state. Most managed care nurses have first gained experience working as a staff nurse in a hospital or clinic before entering managed care. Others have backgrounds in social work and later go on to earn their nursing license. With experience, you can proceed to become board certified through the American Board of Managed Care Nursing.

What Is the Career and Salary Outlook for a Managed Care Nurse?

The career outlook for nurses overall is excellent, and those who specialize in a particular area of health care, such as managed care, are often highly sought-after. You can expect even more job openings in this field of nursing over the next 15-20 years as the baby boomer generation ages, placing a greater demand on managed care services through Medicare. The overall employment of registered nurses is projected to grow by 22 percent between 2008 and 2018, according to the U.S. Bureau of Labor Statistics. The average annual salary for a managed care nurse is $51,000, according to, a site that calculates average salaries based on what is listed in the job postings it receives. A number of factors can affect your salary as a managed care nurse, including how many years of experience you have, what certifications you have, what region of the U.S. you live in, and whether you are working in a metropolitan or rural area.

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