2005 Salary Survey Results
Case managers still are fighting to prove their value
Challenges, opportunities are in the future
Salaries for case management are increasing, but the vast majority of case managers are working far more than the traditional 40-hour week and are being asked to take on expanded duties that may include health coaching, utilization management, motivational interviewing, and disease management.
More than 94% of respondents to the 2005 Case Management Advisor Salary Survey reported a salary increase during the last year. At the same time, they report putting in long hours. In fact, almost 88% report working more than 40 hours a week, with more than 19% working more than 50 hours a week.
The survey was mailed to readers in the June issue. More than half of the respondents (53%) were case management directors. Other respondents were case managers, (41%) and case management company owners.
The highest percentage of respondents (53%) reported getting a 1% to 3% raise, followed by 24% whose salary increases were between 4% and 6%. Nearly 12% reported raises of 7% to 10%, with nearly 6% receiving a raise of 21% or more.
About 53% of respondents report salaries in the $60,000 to $99,000 range, with almost a third (29.4%) reporting salaries in excess of $100,000 and 17.7% reporting pay of $60,000 or less.
CMs are being asked to do more with less
Case managers in all settings, particularly managed care, are being asked to do more with less, reports Mindy Owen, RN, CRRN, CCM, principal of Phoenix HealthCare Associates LLC, a Coral Springs, FL-based consulting firm specializing in case management, disease management, and managed care development and education. She also is chair of the Commission for Case Manager Certification (CCMC).
As companies downsize and combine, they are pulling together job functions, such as utilization management, disease management, and case management that used to operate in separate silos.
"As I go around the company and visit different HMOs, one of the things I hear more often than not is that the caseload is increasing and becoming more varied," Owen reports.
"Many case managers at HMOs have a generalist population of members they are managing, a population of chronically ill patients, and utilization management responsibilities," she says.
New trend?
HMOs are bringing in nonprofessional support staff to do more triage or firstline intervention in a call-center format and referring complicated member requests to the professional case managers, Owen says.
Since 2002, the Case Management Society of America (CMSA) has been closely following CM trends related to shifts within the industry as well as shifts related to the role and function of the individual case manager, says Jeanne Boling, MSN,CRRN, CDMS, CCM, executive director of the Little Rock, AR-based organization.
The surveys clearly indicate a shift toward integration of roles, she notes.
"That is to say, case management positions increasingly include traditional utilization management, case management as well as disease management functions. Across the spectrum of case manager employers, this integration of the front line is supported by a wide variety of systems, and all to varying degrees of integration," Boling says.
Employers who post jobs on the CMSA CareerCenter web site have begun to list certification as a basic requirement with increasing regularity, she reports.
"While the CCM is the most frequently cited CM certification, many simply state certification preferred,’ and do not cite a particular credential," Boling says.
The nursing shortage is affecting the supply of case managers in other settings because hospitals continue to face a recruiting crunch and are offering higher salaries, says Cathy Mullahy, RN, BS, CRRN, CCM, president
of Options Unlimited, a Huntington, NY, case management company.
"Case management organizations were once more able to attract nurses who were seeking to move from a strong hospital background to a nine-to-five job with a little less stress. Now salary packages for hospital-based nurses have made it hard for us to recruit, and there is stress in case manager positions now, too," she says.
Although Mullahy’s company, a division of Matria Healthcare, offers a 401K and tuition assistance, the shrinking pool of qualified people and rising salaries in the hospital and insurance industry have made it challenging for the small company to attract highly qualified staff.
At the same time, as nursing professors retire, there are fewer experienced professionals teaching graduate and undergraduate programs for case managers.
"While the need is growing, the ability to educate in the way we need to is shrinking. When nurses from different settings want to become competent care managers, a crash course is not enough, and there are fewer and fewer places where they can receive the training they need," Mullahy says.
(Editor’s note: To access the CMSA salary survey, visit the organization’s web site at www.cmsa.org.)
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