2006 Salary Survey Results
Nursing shortage contributes to challenges in hiring CMs
Raises are smaller, hours are longer
With the nursing shortage becoming more acute and hospitals offering such perks as sign-on bonuses to attract bedside nurses, case management directors in all arenas are feeling the pinch.
The nursing shortage is having a direct effect on the ability to recruit case managers, making it more of a challenge to hire qualified case managers, says Catherine Mullahy, RN, BS, CRRN, CCM, president of Options Unlimited, a Huntington, NY, case management company, a Matria Healthcare company.
"While I no longer own my own company, I am an employee of a very large national organization that is experiencing these challenges," she says.
Along with the nursing shortage, case managers are challenged with smaller salary increases than in past years and are being asked to work longer hours, according to respondents to Case Management Advisor's 2006 Salary Survey.
The 2006 Salary Survey was mailed to readers of Case Management Advisor in the June 2006 issue. Half of the respondents were case management directors and half were case managers.
The nursing shortage problem is likely to get worse as nursing school faculty members retire and there are few candidates to take their place and teach new nurses, points out LuRae Ahrendt, RN, CRRN, CCM, nurse consultant with Ahrendt Rehabilitation in Norcross, GA.
"The candidate pool simply is not there. Many of the nurses who apply for jobs with us are in their 60s and ready to retire in a few years. They have 25 or 40 years' experience and are coming from some other managed care setting that is in flux," says Margaret Leonard, MS, RN, FPN, CM, vice president of clinical services for Hudson Health Plan, in New York's Hudson Valley.
The challenge with hiring older nurses is that many do not have the kind of extensive experience with data systems that is required of case managers in today's fast-paced managed care environment, she notes.
"Case managers coming to the managed care arena need to be able to use computers and they need to know data analysis. This is something of a challenge for nurses who are accustomed to working with paper system," Leonard says.
Salaries vary
Salaries for case managers vary depending on the area of practice, points out B.K. Kizziar, RNC, CCM, CLP, owner of B.K. & Associates, a Southlake, TX, case management consulting firm.
"Hospital case managers seem to be the lowest on the pay scale, with case managers who practice in managed care settings near the top. Salaries for independent case managers can run the gamut because they are as busy as they want to be," she says.
Kizziar points out that case managers in the managed care arena have another advantage over nurses in hospitals and other settings: Managed care case managers typically work regular office hours five days a week.
About half of respondents to the survey report salaries of $70,000 or more, and 43% report pay of $50,000 to $69,999; the rest (7.14%) report salaries of between $30,000 and $39,999.
Raises down
Only 71.4% of case managers responding to the survey reported getting a raise last year, compared with 94% of respondents to the 2005 survey. The highest percentage of respondents (50%) reported getting a 1% to 3% raise, followed by 21.4% whose salary increases were between 4% and 6%.
At the same time that fewer people are choosing nursing as a career, many of the nurses who are coming along today are working at the bedside for a few years, and then pursuing other avenues in the health care field, such as working in their hospital's information technology department, Ahrendt adds.
"I'm concerned about who is coming behind me in case management because so many of today's young nurses are looking at other options," she says.
There's already a shift to case managers who are not nurses, she points out.
"In the rehabilitation field, there are a lot of case managers who are therapists or rehabilitation counselors. The face of case management is changing," she says.
At Miami Jewish Home and Hospital for the Aged, the majority of staff serving as case managers has a bachelor's degree and a background in social work and is paid at a lower level than RN case managers, says Betsy Pegelow, RN, MSN, director of special projects.
"Many of our patients have far more social needs than clinical needs; and since those are not typically reimbursed, we employ social workers instead of nurses in the position," she says.
Experienced nurses who work as case managers get much higher salaries than social workers.
Workloads increase
Today's case managers have to do more than ever before as additional pressures are put on providers by payer sources.
"There is a lot of emphasis in making sure every need is addressed and documented in detail. They have to do a tremendous amount of paperwork in addition to face-to-face or telephone contact," says Pegelow.
As a result, case managers are working longer hours in order to take care of their additional duties. More than half of respondents to the survey (53.9%) report working more than 40 hours a week.
What job seekers want
When case managers are interviewing for a job, they take benefits, training, caseloads, and the potential for overtime pay into account, Mullahy says.
Case managers are appreciative when their employers pay for their continuing education, she adds.
Hudson Health Plan pays for case manager certification and for the review course and gives case managers a $3,000 salary increase when they obtain certification.
"It's the appropriate thing to do. Why not make the nurses feel like all their efforts are worth it?" Leonard says.
Many organizations, particularly hospitals, don't offer any pay differential for case managers who achieve certification, Kizziar says.
"Case manager certification is not pursued with enthusiasm if is not rewarded by the employers," she says.
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