Wednesday, January 24, 2018

Student Interview with Managed Care Nurses

People who are considering nursing and nursing specialties as a career option will have a ton of questions to ask and research to be done before and after they commit to an educational program. Here, within the American Association of Managed Care Nurses (AAMCN), we get many students who inquire about what it takes to work as a nurse in the managed care arena. We have named some of these popular questions below and our AAMCN Leadership Council has provided insightful answers. 

Students earning their initial nursing degree are invited to join AAMCN at the discounted membership rate of $15. As a member, they receive all of the regular member benefits like our Mentor Program, continuing education activities, our career center and more...

What kinds of problems do you deal with?


  • Team development (i.e. pursuing additional education, certifications, or other positions)
  • Hiring, training, staff education
  • Ensuring staff have appropriate tools to do their jobs
  • Budget and staff funding
  • Projects (regional and national)
  • Outcome measurements
  • Uncertainty with the current political process and health plan implications
  • Meeting regulatory and accreditation requirements
  • Managing challenging members
  • Taking all of the above into consideration when preparing responses to RFP (request for proposal) for new business, and then ensuring all areas are covered when working on implementation and preparation for readiness 

What kinds of decisions do you make?


  • Budget planning
  • Hiring and staffing decisions
  • Work collaboratively with Human Resources and other members of the care coordination team
  • Team placement for projects (i.e. matching team member interests with the project)
  • Patient management
  • Processing of new clients
  • System/program selections
  • Strategic decisions related to the functioning of the department
  • Decisions related to Clinical Services as a function of work stream lead in implementation, and many initiatives affecting clinical services in our Clinical Strategic Initiatives team
  • All decisions made put the member FIRST


How does your job affect your general lifestyle?

  • Encourages one to think ethically in work and personal life with an emphasis on kindness and the ‘Golden Rule’ (do unto others as you would have them do unto you).
  • Ultimately, we are all accountable to the members we serve, and some contracts require responses in a VERY timely manner.
  • It varies with time of year and the status of projects. When one is close to Readiness Review, Go-Live and just after, hours can be long. Our UM Nurses do feel stretched at times, especially close to holiday time as they work diligently to complete discharge. planning/reviews so the Member gets what he/she needs for a successful transition.
  • The accountability and responsibility for the department and meeting the membership needs can interfere with work-life balance, and that is why it is important to prioritize.


Is it important to keep up with current issues and trends in the field?

  • Always continue to keep up with current educational activities and collaborate with colleagues. Staying current will improve your job security.
  • Diversify your skills and competencies. Keeping your skills up to date, being aware of what is happening in the industry and political environment is crucial.
  • What related fields do you think I should consider looking into?
  • Other health care careers, such as Ultrasound, Echocardiography, Informatics, Data Analytics, Health Care Compliance, Program Integrity, and Government jobs


What kind of education, training, or background does your job require?

  • RNs, LPN/LVNs, social workers, professional counselors, and other healthcare workers can work in a managed care capacity.
  • Employers will list the required education and training for an open position, but often place candidates who have achieved specialty education high in their consideration.


What are the most effective strategies for seeking a position in the field?  

  • Prior experience (but not mandatory)
  • Knowledge, expertise, and the drive to learn
  • Sustained enthusiasm
  • Computer literacy
  • Awards, recognitions, or certifications achieved
  • Networking with professionals in the community