What Is a Case Manager? Specialities, Duties and Salary

By Indeed Editorial Team

Published 14 July 2021

The Indeed Editorial Team comprises a diverse and talented team of writers, researchers and subject matter experts equipped with Indeed's data and insights to deliver useful tips to help guide your career journey.

In the medical field, a case manager offers patients specialised care that spans various teams and facilities. This job involves coordinating care for illnesses and injuries that require individualised or long-term treatment. Understanding what a case manager does can help you know if this job is suitable for you and start a career in the sector. In this article, we explore what is a case manager, their primary duties, average salary and how to become one.

What is a case manager?

A case manager is a specialised social worker and healthcare professional who is responsible for overseeing and coordinating the continued care of clinical patients. They usually work with chronically ill patients and patients who need long-term treatment, ensuring effective and high-quality care that addresses specific and personalised needs.

Since they don't administer clinical care directly to the patient themselves, a case manager is a managerial role. They work to ensure that health professionals assist in improving patient's life's and have the exact knowledge of each patient's individual case. As health professionals, they must also advocate on behalf of their patients because patients are not often in a position to advocate for themselves.

What are the responsibilities of a case manager?

The primary responsibility of the case manager is to enhance the quality of patient management. Each patient requires their own specific care, and their duties apply to most of their clients. Their responsibilities include the following:

Coordinating and providing safe and client-centred care
Finding appropriate clinical care teams for each patient's needs
Assessing patients for necessary care or changes to current care plans
Understanding individual patient needs
Linking clients with products and services they require
Helping clients achieve wellness and autonomy
Coordinating with social services to help in care administering
Coordinating with insurance companies or other financial services to pay for care
Advocating for patients to communicate to medical, financial and social services
Transferring patients from one team or facility to another
Creating patient discharge plans

Is a case manager the same as a social worker?

A case manager and a social worker are two essential roles in the community services industry. They are responsible for handling clients and directing them to the right services of care when needed. However, the two positions are different, and they have distinct tasks. The main difference is that a social worker focuses on improving an individual's personal life and assists their clients in managing difficult life circumstances, such as poverty, disability and illness. Whereas, a case manager assists in practical tasks, such as communicating with welfare services if they struggle financially or a rehabilitation program if injured.

These are some of the roles of a social worker:

Evaluate the needs of a client
Provide counselling to individuals and families
Record and maintain client records
Advocate human rights
Follow up with clients to ensure they get the services they need

A social worker can work within a speciality such as child care, family care, alcohol and substance abuse or mental health.

Specialities of a case manager

Like many other healthcare professionals, a case manager's work environment depends on their specific expertise and their patients' needs. Some examples of a case manager's specialities are the following:

Hospital case manager

A hospital case manager is usually a nurse who ensures that professionals use healthcare services appropriately and efficiently. They make sure that patients get the care they need and administer it through proven methods in an appropriate setting. These professionals also perform discharge planning, which is the process of predicting the patient's medical needs after they leave the hospital.

A primary hospital case manager's responsibility is to assess the patient's health insurance plan, communicate with the insurer and multiple providers, and be as cost-effective as possible. They may also negotiate coverage benefits between a health insurer, provider and patient.

Related: 16 Hospital Jobs to Consider

Health insurance case manager

A health insurance case manager is a professional who receives information from hospital case managers, home healthcare companies, social workers or other healthcare providers. They may visit a patient in the hospital depending on the situation, the organisation and the location. Their goal is to make sure that a patient receives appropriate and high-quality care whilst being as economically efficient as possible.

Some health insurance case managers focus on a specific chronic disease or illness called disease management. For instance, they can teach a patient how to manage a chronic disease, such as diabetes, so they know how to keep their blood sugar levels within a healthy range, or they can work with people with HIV and ensure they receive monthly medications properly.

Home health case manager

A home health case manager provides hands-on care, coordinates teams and communicates with health insurance companies and other healthcare professionals, such as physicians and other caregivers. They often supervise visiting nurses in patients' homes, coordinate and implement a plan with the client and the service provider, and make adjustments when needed. One of the main differences from other social workers is that a home health case manager is not a nurse and might not offer some of the services typically delivered by medical professionals.

How to become a case manager

There are many paths to becoming a case manager, with options to transition from other related healthcare professions, such as nursing and social work. Whether you want to start your career as a nurse, social worker or other related professional, here are some common steps that can lead you to become a case manager:

1. Complete a certificate or a diploma

You can start by completing a nationally recognised Certificate III in Community Services or a Diploma of Community Services. These qualifications prepare you for entry-level jobs in the field as a community service worker and work under the direction of management to provide support to individuals and communities. If you complete a Certificate III, you can also grow your career by pursuing a Certificate IV. If you choose a Diploma, you can look for further bachelor's degrees.

2. Obtain a bachelor's degree

A bachelor's degree typically takes three years to complete. You can look for a relevant healthcare bachelor's degree or any other closely related to healthcare professions. Then, you will can transition to be a case manager in the future. For instance, you can obtain a Bachelor of Applied Social Science (Community Services), a Bachelor of Community Services or a Bachelor of Nursing.

3. Get a license

Nurses and social workers require official licenses or certificates to work in the country. Consider researching your local and professional licensing requirements to get one. For example, if you complete a bachelor's degree in nursing, you can then become a registered nurse or midwife with the Nursing and Midwifery Board (NMBA).

4. Gain practical experience

Before becoming a case manager, most employers require a minimum of experience in a related profession. You can gain practical experience in the work placement while you're studying for your degree, working as either a nurse or social worker, or working in other related professions. For example, a case manager works closely with insurance companies, so any experience working for insurance companies may benefit you.

5. Get a case management certificate

Most states require an official certification to work as a case manager. You can complete the Case Management Society of Australia & New Zealand & Affiliates (CMSA) exam, which is the national regulatory body for certified case managers. Applicants need to meet the eligibility requirements within one of the four vocational pathways.

Skills needed to be a case manager

Since they act as a bridge between doctors and patients, case managers can benefit from a particular set of skills:

Clinical skills: these are hard skills that help case managers to explain the medical process to patients and their families. With these skills, they can understand the patient's health conditions and treatments that other healthcare professionals perform on them.
Empathy: case managers can benefit from understanding patients' feelings and backgrounds. Being able to relate to them, these professionals can advocate for their needs. Patients can also trust case managers who show empathy.
Organisational skills: a successful case manager is organised in order to provide their patients with the best care possible, addressing all concerns and multitasking when needed.
Communication skills: these soft skills help case managers to practise active listening and transmitting clear information to patients, doctors and insurance companies. They need excellent communication skills to relay important medical information between parties.
Collaboration and teamwork: a successful case manager collaborates on a care plan with patients and their family members. They can also connect them with additional resources, teams and specialists. In order to accomplish that, they need to have excellent collaboration and teamwork skills.

What is the average salary of a case manager?

A case manager's salary depends on the state they work in, experience, level of education, the organisations they work with and many other factors. The average base salary of a case manager is $86,167 per year. Salaries are similar to those of other social workers.

Please note that none of the companies mentioned in this article are affiliated with Indeed. Salary figures reflect data listed on Indeed Salaries at time of writing.