How 3 Nurse Case Managers Became Part of the Telehealth Revolution

Updated November 2023. Originally written by Kimberly Gohringer.

In the rapidly evolving world of healthcare, the rise of telehealth has been nothing short of revolutionary, offering new avenues for patient care and challenging traditional healthcare models. At the forefront of this transformation are three pioneering nurse case managers who have seamlessly integrated into the telehealth framework, redefining patient engagement and care coordination. Their stories, a blend of innovation, adaptability, and unwavering commitment to patient well-being, offer an insightful glimpse into the future of healthcare. In this article, we will delve into their journeys, exploring how these dedicated professionals became instrumental in shaping the telehealth landscape, thereby impacting the lives of countless patients in the process.

Meet Anne Llewellyn

Anne is an RN-BC, MS, BHSA, CCM, CRRN and nurse advocate, and is a former president of the Case Managers Society of America. We asked Anne a few questions about how she’s seen the Nurse Case Manager role evolve from mainly on-site to remote positions, and why she thinks the industry works so well that way.

Q: When did you first start in nurse case management and what were your primary tasks?

A: I started in 1988 with the company that is GENEX Services, LLC today, and at that time everything was done without computers. This was before managed care, so we did a lot of cost/benefit analysis – we had to figure out what the cost per day for hospital stays were, what the alternatives were, and whether the patient could stay at home with IVs instead.

Q: How have you seen the industry change since then?

A: In the 1980s and 90s, many people had million dollar limits on their health care plans, so we as nurse case managers helped the patient conserve insurance dollars until they could reach Medicare. Today, due to managed care, the nurse case manager advocates for each patient according to their individual needs.

I like the focus being more on the patient and less on negotiating costs. Before managed care, the most expensive piece of equipment in a hospital was a pen in the hand of a doctor. They could write a prescription or orders for anything they wanted. Today, those costs are controlled through utilization management to ensure treatment is evidenced based.

Q: How has telecommuting impacted the role of the Nurse Case Manager?

A: Today, there are entire companies like GENEX Services, The ALARIS Group, Inc., and dozens more who manage Telecommuting Nurse Case Manager positions in order to ensure safe, effective and cost effective care coordination.

Those companies have realized that we can do our jobs effectively from anywhere that we have a phone, computer and internet access, and that hospitals and providers can save money by not providing physical office space for telephonic nurse case managers.

Now, we have more time to concentrate on managing the care for the patient – what they need, when they need it, at the right time, and in the least restrictive setting. That’s our mantra of what case management does – to work with each patient individually. We try to get them moved from ICU to the next step down sooner, for example. Studies show that patients do better in a less restrictive setting, so we strive to make sure they are moved when ready.

Case management works with the healthcare team to make sure care is effective and we help patients navigate the healthcare system by interpreting and explaining it – often with their doctor if a patient is unsure. If an elderly person has seven doctors, we try to make sure they’re all talking to each other. This takes a lot of phone coordination, email coordination, and correspondence back and forth.

Working remotely or as a telephonic nurse case manager helps us get more done in less time. We can step back and look at a patient from a holistic perspective, and be a liaison between the family, patient, and payer. Remote case management is ultimately about providing good nursing care.

Q: Any last thoughts about where the role of Nurse Case Manager is going in the future?

A: Overall, Nurse Case Managers are retiring faster than we’re bringing new managers in. There are good training programs out now and more positions than ever, so I encourage nurses to look into it and also do their research to find a company that fits their personal and professional goals.

Meet Ashley Crissone & Cat McDonald

Ashley Crissone is an RN, CHPN nurse case manager who works for Cat McDonald, owner of Footprints Case Management in Davidson, NC. Cat is an RN and BSN. Footprints is a CAP-C provider, which is a Community Alternative Provider for Medicaid families. They partner with the Division of Medical Assistance (DMA) through the Department of Health and Human Services to provide care and services to medically fragile children.

Q: When did you first start in nurse case management and what were your primary tasks?

A: (Ashley) I started in nurse case management after a few years as an RN on the floor. In my early 30s, I had a condition called Chiari, which I needed brain surgery for. After that, I could no longer lift patients and do other physical tasks on a day-to-day basis.

Nurse case management, particularly remote nurse case management, works for me because I still get to work for and with patients, but I do about 80% of my work remotely now. This work is rewarding and gives me a way to care for myself and still advocate for my kids.

Q: Cat, how did you get started in nurse case management?

A: (Cat) I’m a nurse and I have three children who are medically fragile and have special needs. I started Footprints Case Management to advocate for them and other families who are in the same situation and need help and guidance to understand the ins and outs of Medicaid. I want to help other families within the special needs community, so it is a win-win.

Q: Ashley, what do you do for your families as a Nurse Case Manager and how does telecommuting impact that?

A: (Ashley) Most of our families have nursing assistance. Families with medically fragile children get a certain amount of money that has to last five years. As a Remote Nurse Case Manager, I help them figure out how to spend it so it doesn’t run out.

We want to help families keep their kids at home. Years ago these kids were institutionalized, so by closely managing costs through a Nurse Case Manager, we can help keep kids out of institutions.

I do about 80% of my work remotely, usually on the phone and computer. I line up oxygen providers, other vendors and align doctors, all in the best interests of my patients. The other 20% of the time, I get to be out in the field and go visit my kids and their families. I go to the family’s home once a quarter, sit down, talk about the budget and set goals for the next three to six months. I don’t do assessments on a daily basis like some telephonic nurse case managers do.

Q: Ashley, can you give our readers an idea of a typical project you might coordinate for one of your families as a Nurse Case Manager who telecommutes?

A: Sure – I have a family that needs a handicapped bathroom installed, because their child has grown and now weighs too much to lift in and out of the bathtub. So, first I contacted a physical therapist to get medical necessity, then I tracked down a doctor’s order for the components, and then I went out to the community and found vendors to give us three quotes that will accept Medicaid’s terms. After all of that was aligned, I asked for permission from the DMA to complete the project. Once the DMA approved the quote, I scheduled the work.

All of this can take anywhere between two and six weeks, depending on the project and how intensive it may be. A lot of my work involves coordination, correspondence, asking the right questions and getting the paperwork lined up correctly to get the work completed in a timely way.

Q: That’s a lot of coordination! Cat, from a business owner’s perspective, what are the advantages and disadvantages of having Telephonic Nurse Case Managers?

A: (Cat) At our agency, we have a mix of nurse case managers and social workers because all of our kids have a medical need. All of the employees can make their own schedule with the technology available today and we can do remote trainings with screen sharing even. It’s great that they can be available to our families when they need help – sometimes questions need to be answered after traditional working hours.

One of the disadvantages I’ve seen is that employees can miss the adult interaction of coworkers. To combat this, we have a private Facebook group they can chat in and we have quarterly dinners to help with connections. We also do an annual family outing which employees have enjoyed!

Embark on Your Telehealth Journey: Explore Remote Nurse Case Manager Opportunities Now

Ready to embark on a transformative career journey in the world of telehealth? If the inspiring stories of these three nurse case managers have ignited a spark in you, it’s time to take the next step. Click the button below to explore a wealth of opportunities in the Virtual Vocations remote jobs database. Discover a range of remote nurse case manager positions that offer the flexibility, challenge, and fulfillment you’re seeking in your professional life. Don’t just read about the change; be a part of it. Start your journey towards becoming a telehealth pioneer today!

What appeals to you about a remote case management nurse job? Connect with Virtual Vocations on Facebook, Twitter, LinkedIn, Instagram, and YouTube to share your thoughts and tips. We’d love to hear from you!