Healthcare has gone through so many changes over the past three years. Now that we are settling into what feels like our new normal, staffing is more of a challenge than ever before. Recently, I had a discussion with hospital leaders regarding the recommended amount of experience when hiring a new case manager. Once the conversation began, there were varying opinions with a focus on ensuring the development of a case manager who works as an advocate for the patients with an understanding of the business of healthcare. Ideally, leaders look for an applicant with 3-5 years of case management experience. We also hope for several applicants to interview and choose from. Unfortunately, in the current market, we are lucky to have one applicant for a position in the first few months that it is posted. While experience is always preferred, an applicant with the right qualities can succeed. The focus needs to be on core curriculum and training from a tenured staff who can educate, orient and offer ongoing mentorship.

So, the question I pose is: can you hire a new graduate or someone with no previous experience as a case manager? My answer is yes, and before you gasp out loud, there are considerations and steps that can assist in hiring the right person with the right qualities to succeed in the demanding role. Below, we will discuss how you can determine those qualities during your search, focus on a successful orientation and develop a program that supports personal growth and advancement as a case manager. For the record, I agree that an experienced case manager is always best. The BUT is that, like the housing market, the inventory is low and the demand is high so thinking outside of the box is necessary to meet the needs of our patients and our communities.

Interviewing For Your Next Case Manager

While completing your interviews, you must think of the qualities required to be an effective case manager. Skills can be taught, but attitude and work ethic must be considered equally as attributes to success. Core qualities are required for an individual to advocate for a patient, confidence to interact with physicians and be assertive enough to facilitate a group in conversations with multidisciplinary teams. Case managers problem-solve under stressful situations and need to work autonomously.  Hiring for these qualities and the ability to handle difficult situations will benefit of the patient, team members and the organization.

While interviewing, use questions that identify excellent communication skills led by critical thinking and self-confidence. Is this person going to be able to multitask throughout the day?  Can they identify and prioritize patients who are ready for discharge today and ensure the plan is in place? The ability to quickly adapt to changes in the plan and redirect the focus required for the patients’ discharge takes patience and skill to prevent discharge delays for complex patients.

Questions that can be asked to look for this candidate who has the attributes that you are looking for may be:

• Tell me about a time when you realized you needed to make an improvement in your communication skills. How did you manage it?
• Tell me a time that you worked with a person whose personality was the opposite of yours. How did you manage your relationship?
• How do you organize your work to ensure that you are the most effective and productive?
• What have you done that was innovative?

Orientation Success and Outcomes

We were not born case managers and we all started somewhere as a new grad. The variation lies in how effectively we were trained when we began. My first job was on a long-term care unit. I was 22 and I looked about 17! I was told that I would receive 6-8 weeks of orientation. The first night, I received orientation and worked alongside a nurse. The second night I was “on my own” due to staffing and the need for coverage of a patient assignment. And the third night I was the charge nurse because she had called off and everyone else working had floated from another unit. Thank goodness, I returned to an orientation schedule the following week. But now, as a leader, I see how the system failed me as a new grad and the lack of support for me to receive proper training. Not to mention patient safety!

Orientation of a new grad, whether as a nurse or social worker, will require additional time to orient than those with prior experience. A case manager boot camp curriculum and education discussing best practices for transitions of care, utilization review, regulatory requirements and need to know items for your community will benefit those coming into the profession. For new social workers, an additional boot camp piece related to key medical wording, diagnoses and disease processes would be beneficial due to their lack of medical education during their social work program.

Retaining Staff and Investing in Staff Advancement         

The knowledge and skills that an organization arms their staff with will pay off through the care provided to the patient and the understanding of the continuum of care for best patient outcomes. Those of you reading this article are involved in the CMSA, which means you are putting in the effort to continue to learn by participating in this community. But are your team members involved? Are those who report to you involved? And if not, why not and how to we get them involved? Think of what can be done to get more of your staff involved in case management associations and certification once eligible. Certifications offer case managers the ability to promote their advanced knowledge to their patients, families, and colleagues. It reflects a higher level of commitment and encouragement of these advances which assists solidify the future of this professional’s path within the case management profession.

The changes in hiring challenges don’t appear to have an end in sight and there won’t be an easy fix to finding experienced team members. Maybe you will not decide to hire new grads but do look at your requirements in your job descriptions. Could you lower the required years of experience to attract more talent? What can you do to adjust your orientation program to have a more comprehensive approach to meet the needs of a new hire with little to no experience? We need to broaden our scope to meet the demands of this new hiring market. Good luck to you all!

Bio: Marie Stinebuck MBA, MSN, ACM is the Chief Operating Officer of Phoenix Medical Management, Inc., the leading case management firm. She has practiced as a nurse for the past 25 years with 17 years in the field of case management and has served in several roles in senior leadership roles in Case Management. Marie has also authored numerous articles, is a weekly contributor on Finally Friday and is a Board Member for the Arizona ACMA.

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