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How to Become a Care Manager

Healthcare is full of rewarding career opportunities for individuals looking to make a difference. Care managers play a unique and pivotal role in bettering the lives of chronically ill patients and improving public health. 

Through ongoing patient communication and education, care managers build strong relationships with patients and encourage them to adhere to wellness goals, pursue preventative screenings, and access healthcare resources. Care managers improve the quality of life for chronically ill patients and help relieve the enormous strain chronic conditions place on the U.S. healthcare system. 

Care managers often work for Chronic Care Management (CCM) companies like ChartSpan, partnering with providers to create personalized wellness plans and extend exceptional care to patients between clinical visits. If you’re interested in a career in care management, let’s explore the job responsibilities of a care manager, the skills needed to excel in the field, and how to pursue a career in care management. 

What is a patient care manager?

A patient care manager engages, advocates, and assists patients in their healthcare journey between clinical visits. They provide care coordination, patient education, and support services such as scheduling appointments, arranging transportation, managing medication refills, and helping patients set goals and adhere to wellness plans. Patient care managers improve overall healthcare outcomes by facilitating communication and ensuring access to care. 

Care management aims to improve the quality of care while lowering out-of-pocket costs by promoting value-based, preventative care. Care managers often work with patients who have multiple, complex chronic conditions. These patients are at higher risk of hospitalization. Care managers act as healthcare ambassadors to these patients, proactively engaging them in positive lifestyle adjustments, chronic illness management, and preventative screenings and immunizations. The education and intervention provided by care managers facilitate positive clinical outcomes and a better quality of life for the patients in the long term. 

In addition, CCM care managers collaborate with patients and providers to ensure the smooth delivery and documentation of Chronic Care Management services. They foster strong relationships with patients by guiding them through their wellness plans, addressing concerns with evidence-based information, and connecting them to valuable community resources. 

Learn more: Care Managers vs. Case Managers: The Differences and Benefits

What are the responsibilities of a care manager?

A care manager’s responsibilities encompass many tasks related to patient education, care coordination, and wellness plan adherence. These responsibilities include:  

• Patient engagement: Engaging patients in their care journey through regular monthly communication
• Medication support: Assisting patients with medication refills and deliveries
• Transportation coordination: Arranging transportation to annual physicals, screenings, immunizations, and other medical appointments
• Resource connection: Locating and connecting patients to Social Determinants of Health (SDOH) resources, including community volunteer opportunities, senior-friendly exercise classes, and financial and housing assistance
• Goal setting: Identifying patient-specific needs and setting care goals to meet these patient needs (as outlined by providers and clinical assessments)
• Care plan management: Maintaining up-to-date care plans through precise documentation of chronic conditions, prescription medications, immunizations, allergies, preventative screenings, surgical history, and family medical history
• Addressing care gaps: Helping to close gaps in care by promoting preventative care services
• Lifestyle recommendations: Recommending practical lifestyle adjustments, self-management tips, and healthy behaviors (aligned with physician-approved wellness plans) 
• Mental health monitoring: Observing a patient’s mental health, delivering depression screenings and reporting results to their provider, and supplying behavioral health resources if needed 
• Health records management: Accessing lab results, documentation, and health records for patients and reviewing and transcribing patient medical records 
• Educating: Providing appropriate, relevant, and timely health education and helpful sources of information
• Patient communication: Responding to patient calls, texts, and emails
• Escalating patient concerns: Alerting nurses or emergency services when appropriate
• Care coordination: Acting as a liaison for the patient when coordinating care between disparate healthcare networks and specialty practices 

Examples of a care manager’s daily workload

As a care manager, your day would involve a variety of tasks based on the needs of patients enrolled in a Chronic Care Management program. Here are a few primary responsibilities you might encounter on a daily basis:

1. Patient check-ins and care plan review

A typical care manager’s day will consist of making outbound calls to patients enrolled in a CCM program and responding appropriately to their needs. 

For example, a care manager may place a call to a patient with both hypertension and arthritis. 

• The care manager will review the patient’s care goals, verifying the patient is achieving their exercise targets and maintaining a nutritious diet. 
• If the patient mentions that they are experiencing joint pain while exercising, the care manager can review their activity plan and recommend alternative, low-impact exercises that may minimize physical stress. 
• The care manager can also review the patient’s medications, ensuring they adhere to their arthritis prescriptions. 
• They will also determine if the patient is overdue for appointments with the care providers monitoring their arthritis’s progression.

2. Addressing barriers to care

Another patient may mention they no longer have access to a vehicle and are concerned about their ability to attend an upcoming cancer screening. 

• The care manager can arrange for transportation for this patient, preventing a gap in care from forming. 
• The care manager may suspect that the patient is experiencing financial difficulties and can subsequently ask questions about their housing security and access to food. 
• They can then locate community resources that may be able to provide assistance to the patient and connect them to the appropriate channels. 

3. Responding to critical situations

A care manager may contact a patient exhibiting signs of confusion and agitation. 

• After noticing the patient is unable to communicate clearly, the care manager can ask questions about other side effects the patient is experiencing and their medication dosage. 
• The patient could indicate that they may have accidentally overdosed on a medication. The care manager can transfer the patient to a registered nurse for triage, and the patient can consent for the nurse to contact EMS services and the members on their emergency contact list. 
• The care manager can then remain on the line with the patient until the paramedics arrive at their home.

Care managers’ daily duties range from guiding patients through self-management techniques to care coordination services and administering life-saving assistance. A care manager’s tasks will differ based on the individual needs of their assigned patients. 

How to become a care manager

Care managers must possess communication skills, health literacy, and problem-solving abilities to excel in this role.

Skills needed

• Strong verbal and written communication: Care managers will interface with patients, providers, and healthcare administrators. They should be able to navigate these conversations smoothly and effectively. Care managers should be adept at building interpersonal connections and communicating with various personalities. 
• Proficient health literacy: Care managers must educate patients on their chronic conditions, symptom management, medication adherence, and preventative care. They should possess a rich knowledge of health services and be able to communicate this information clearly to patients. 
• Patience and compassion: Care managers assist patients with multiple chronic illnesses. These illnesses can affect the patient’s moods and cognitive abilities. Care managers must be empathetic, accommodating, and understanding of their patient’s limitations, preferences, and challenges. 
• Can-do, problem-solving attitude: Care managers help patients access preventative care, local resources, and health records. They may encounter obstacles when coordinating care for their patients. Care managers should be eager to find solutions to these problems and aid the patients in obtaining the care and services they need. 
• Excellent listening skills: Many patients enrolled in CCM have limited social and familial circles. Their monthly calls with care managers may be one of the few opportunities they have to unburden their concerns onto an objective third party. Care managers should be adept at listening to patients' frustrations and fears and identifying new or concerning information. This information should be documented and passed on to the relevant healthcare provider.   
• Organization and multi-tasking: Care managers will process diverse requests from patients, providers, healthcare networks, and other CCM team members. They must be able to execute these tasks simultaneously without sacrificing detail. Care managers need to be highly organized and flexible multi-taskers.   
• Healthcare qualifications: Depending on the level of care they will be providing, care managers may be required to hold specific medical qualifications. Many organizations hire Registered Nurses (RNs), Licensed Practical Nurses (LPNs), Certified Medical Assistants (CMAs), Certified Nursing Assistants (CNAs), and Registered Medical Assistants (RMAs) for care management roles. 

Licenses are required to become a care manager

Every state has its own licensure rules, and qualifications will differ from state to state. In some states, only licensed nursing staff can provide clinical services under Medicare’s CCM program. Other states allow for non-licensed care managers to administer care coordination services. For example, CA, CT, MD, PA, OR, and NJ all require licensed nurses to provide clinical services under Medicare’s CCM program. 

Care managers can also pursue additional certifications, like the Professional Association of Health Care Office Management (PAHCOM)’s certifications in medical management or the American Health Information Management Association (AHIMA)’s certifications in health information management. While these certifications are not required for a career in care management, they can help distinguish an applicant’s resume and build crucial professional skills.   

What is the difference between a care manager and a care coordinator?

Care coordinator roles are frequently entry-level positions that assist in documentation retrieval, patient communication, record transcription, refill assistance, and locating resources. These roles are usually staffed by certified nursing assistants, certified medical assistants, and registered medical assistants. These roles typically do not require RNs or LPNs to fill them, while care manager roles often do. 

Learn more: 11 Features of the Best CCM Companies.

What are the benefits of a career in care management?

Care management offers individuals a flexible, remote work opportunity for those looking to facilitate high-quality healthcare experiences. Every day’s work will be refreshing and different for a care manager. This makes the career an ideal opportunity for those seeking stimulating work environments that create meaningful impacts.

• Opportunities for licensed nurses (RN, LPN) around the nation
• Remote work
• Flexible schedule 
• Ongoing training and growth opportunities 
• Positive influence on the lives and longevity of patients through improving symptom self-management, aiding patients in SDOH assistance, and reducing readmissions and hospitalizations.   
• A crucial part of supporting public health infrastructure, lowering medical costs, encouraging chronic disease management, and relieving overburdened emergency services 

Join ChartSpan’s care management team and transform patient lives

When care managers join the ChartSpan team, they play an integral role in the health of individuals and the broader health of the American public. At ChartSpan, one of the industry’s leading providers of full-service CCM programs, we recognize that our care managers are one of our most vital assets. We work diligently to provide ongoing team member training, flexible scheduling, and a positive work culture for our employees.

Care managers are our patient advocates, educators, and supporters. They are crucial to our CCM programs' success and our enrolled patients' clinical outcomes. 

Explore our job opportunities today and join us in shaping the future of chronic illness management.

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• 5 Strategies to Improve the Quality of Healthcare
• The Secrets of Successful Chronic Care Management Training and Onboarding
• Health Equity and SDOH: The Impact of CCM