CMCN - Certified Managed Care Nurse Jobs

What Does A Certified Managed Care Nurse Do?

Certified managed care nurses (CMCNs) provide oversight of patient care focused on preventive measures to help keep costs down. In managed care, patients have permission to see only specifically designated healthcare professionals. CMCNs are registered nurses (RNs), licensed practical nurses (LPN/LVNs), or nurse practitioners (NPs) who have acquired specialized managed care knowledge. Patients and medical professionals alike rely on them to make sure a managed care system operates without serious problems, according to Nurses Without Borders.

What Are The Job Roles For A CMCN?

Acts as a liaison among patients, healthcare providers, insurance companies, medical facilities, and government agencies

  • Works with diverse groups of patients
  • Educate patients about preventive care
  • Job Characteristics
  • Work is fast-paced.
  • Responsibilities are primarily managerial.
  • Jobs tend to be structured.
  • Work might or might not include significant face-to-face patient contact.
  • Duties are multifaceted.
  • Work requires good communication skills.

What Education & Certification Is Needed For A CMCN?

To become a CMCN, an individual must become a licensed nurse (RN or LPN/LVN). The first step is graduation from an approved nursing education program, either through a hospital training program of by earning an Associate of Science in Nursing (ASN) or a Bachelor of Science in Nursing (BSN) from an accredited school, according to NursingSchools.net. 

After finishing a nursing program, nurse candidates must pass the National Council Licensure Examination (NCLEX-RN) to become eligible for licensing in the state of their choice.

A majority of managed care nurses initially worked as staff nurses before moving into managed care. Some have social work backgrounds and entered managed care after becoming licensed as a nurse. Nurses interested in advancement often opt to pursue a master’s or doctoral degree, sometimes in an area like leadership and management, Nursing-School-Degrees reports. Attainment of the CMCN designation demonstrates a commitment to excellence in managed care nursing.

Related: Advantages And Disadvantages Of Getting An MSN

What Are The Degree Requirements For A CMCN?

There is none. CMCN candidates must be licensed RNs, LPN/LVNs, or NPs and complete a specific home study program or have equivalent educational experience. However, these universities offer outstanding nursing programs:

  • Western Governors University
  • Duquesne University
  • Vanderbilt University

What Certification Is Needed For A CMCN?

The American Association of Managed Care Nurses (AAMCN) recognizes the CMCN designation as certification for managed care nurses. The American Board of Managed Care Nursing (ABMCN) administers and monitors the examination and the credential.

To sit for the exam, candidates must have a valid nursing license and finish a managed care home study program that covers an overview of managed care, healthcare management, patient issues, and healthcare economics or provide acceptable educational experience for review. 

What Are the CEU Requirements As A CMCN?

ABMCN guidelines require completion of 25 hours of continuing education every three years for certification renewal. These hours can be the same type of hours used to renew nurse licensing or other nursing related credentials. Each state also has specific continuing education requirements for nurse licensing. The list is available at NURSE.com.

Most employers now favor continuing education offered as either online or on-site training. Quite often, the subject is regulatory requirements.

Where Can I Work As A CMCN?

The most common workplaces for CMCNs are:

  • Health management organizations (HMOs)
  • Preferred Provider (insurance) Plans (PPOs)
  • Clinics
  • Hospitals
  • Community health centers
  • Government agencies
  • Social service programs

Vonda J. Sines is a freelance writer based in the Washington, DC area. She specializes in health/medical, career, and pet topics and writes extensively about Crohn's disease. Her work has been published at EverydayHealth, Lifescript, womansday.com, Yahoo! Health, Catholic Digest, Angie's List Health, and on many more sites.

Next Up: 80% Of Nursing Workforce Should Have A BSN By 2020

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