2009 Salary Survey Results

Hours, responsibilities increase for case managers

More practice settings want coverage seven days a week

Case managers are more experienced and are putting in longer hours than ever before, but aren't necessarily getting more compensation for it, according to the results of the 2009 Case Management Advisor Salary Survey.

The 2009 salary survey was mailed to readers of Case Management Advisor in the June 2009 issue.

The majority of the respondents (75%) were case management supervisors or directors and 12.5% were case managers. The rest held other positions.

More than a third of the respondents (37.5%) reported that they received no salary increase last year. Another 37.5% reported raises of 1% to 3%, and 25% received a raise of 4% to 6%.

At the same time, respondents to the survey reported putting in long hours. The vast majority of respondents to the survey (87.5%) reported working more than 40 hours a week, with more than 25% reporting working 56 hours or more.

Case managers who responded to the survey are older and experienced, with 75% reporting 22 years or more experience in the health care field and 62.5% who have been a case manager 10 years or longer. Only 12.5% of respondents reported being under 41 years old.

While their responsibilities are increasing, staffing in case management departments seems to be staying stable. While 25% of respondents reported that their staff had decreased, 37.5% reported an increase in staff, and the same percentage reported that their staff stayed the same.

For the first time in many years, the nursing shortage doesn't seem to be impacting case management hiring, says Catherine M. Mullahy, RN, BS, CRRN, CCM, president and founder of Mullahy & Associates, a case management training and consulting company.

In fact, she reports that a nurse recruiter told her that she has as many as 250 applicants for every two positions.

As the Case Management Society of America contact for her area, B.K. Kizziar, RN-BC, CCM, CLP, frequently gets e-mails from recruiters with positions to fill. However, they are all management positions at the corporate or director level, she says.

"We're not doing very much to mentor new and younger people into case management. This could be a big problem in the future," says Kizziar, owner of B.K. & Associates, a Southlake, TX, case management consulting firm.

Kizziar says that a fellow case manager who works at a health plan reports that her department has two vacancies.

"They've opened up these positions for a few days, then closed them again. They are waiting to see what will happen with health care reform," she says.

Some nurses go into case management thinking it's one thing and then find out that it's something else, Mullahy reports.

They're working longer hours and spending more time on paperwork than interacting with patients, she adds.

At one time hospitals were able to capitalize on the fact that case managers work regular business hours Monday through Friday, she points out.

"Now, because of pressure from payers, hospitals are staffing their emergency department and other areas of the hospital seven days a week and sometimes 24 hours a day. They often have case managers coming in on weekends to handle discharges," Mullahy says.

At the same time, insurers have extended the hours of their nurse triage lines and disease management nurses to be more accessible to members, she adds.

"Case management in many settings is no longer a Monday-through-Friday, 9 am to 5 pm position. If the chronically ill people are still working, someone needs to call them in the evening when they're at home. There is an increasing need for evening and weekend staffing," Kizziar adds.

Hospitals are extending the hours of case managers, particularly in the emergency department.

"Those of us who are experienced tend to feel like we've already paid our dues by working weekends and holidays when we were floor nurses," Kizzier says.

The majority of health plan positions are still Monday through Friday, Kizziar adds.

"Health plans are still safe havens for those who want to work regular hours," she says.

In addition, many health plans offer better benefits than hospitals, she adds.

"Particularly as they mature, more and more people are looking for better benefits rather than higher salaries," she says.

Hudson Health Plan in Tarryton, NY, offers a benefit package that includes paying for case managers to join the Case Management Society of America (CMSA) and their local chapter, says Margaret Leonard, MS, RN-B-C, FNP, senior vice president for clinical services at Hudson Health Plan and president of CMSA.

In addition, the health plan pays for case managers to take a review course and to sit for the certification exam. Case managers who become certified receive a $3,000 bump in salary.

"I hope more and more employers will start to value case management certification and increase the salary for case managers who become certified," she says.

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