Managed care nurse

Managed care nurses help elderly and underserved patients, who may rely on government-funded healthcare like Medicare or Medicaid, to stay as healthy as possible.

Required education

ADN or BSN

Average annual salary

$96,000

Payscale.com (Jan. 2026)

Varied

Take on different tasks, patients, and situations every day.

Managerial

Oversee other nurses and help improve healthcare for all.

Fast-paced

React and make decisions quickly in demanding conditions.

Patient-facing

Work hands-on, directly with patients.

Structured

Follow a routine that allows you to anticipate and prepare for every situation.

What is the role of a managed care nurse?

You’ll be the liaison between your patient, government agencies, their insurance company and doctors to make sure they get quality care.

What you’ll do as a managed care nurse

Assessment

You’ll keep a close eye on your patient’s physical, emotional and psychological state to make sure they receive the right care.

Education

You’ll teach patients and caregivers about preventive care, encouraging them to go for regular checkups and vaccinations to stay healthy and thereby reduce medical costs.

Evaluation

You’ll assess patients’ care plans and make recommendations to ensure they’re beneficial and cost effective.

Treatment

You’ll take care of patients at different hospitals and medical facilities, administering medication and creating treatment plans.

medical care adviser on virtual consultation with patient

Where you’ll work as a managed care nurse

Managed care nurses work in a variety of settings, including:

Health insurance companies
Hospitals
Telephone triage centers

How to become a managed care nurse

Get an Associate’s Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN), taking elective courses in social work.

When considering a future nursing career, it’s important to explore the different nursing programs available and the paths they offer. With various options like associate degree programs, bachelor’s degree programs, and direct-entry master’s degree programs, prospective students can choose the educational path that best suits their goals and interests.

Pass the NCLEX-RN and work as a Registered Nurse.

The National Council Licensure Exam (NCLEX) is the all-important step between graduating from nursing school and becoming a nurse. It’s a standardized test, set by the Board of Nursing in each state, that makes sure you have the knowledge and skills you need to work in the field of nursing.

While there is no specific certification, it’ll be helpful to get your Managed Care Nursing Certification from the American Board of Managed Care Nursing.

You’re ready to work as a managed care nurse!