Top 20 Interview Questions & Answers for RN Case Manager Roles – 2025

Preparing for an interview for an RN case manager position? This guide provides a list of essential questions and answers that will help you showcase your experience in patient care, case management, and team collaboration. Whether you are applying for a role in a hospital, home health agency, or managed care company, these questions cover all key areas of the job.

General Questions

• 1. Tell us about your experience as an RN case manager.
  As an RN case manager, I have been responsible for managing patient care, coordinating with healthcare teams, and facilitating the discharge process. I have experience in both acute and community care settings, working with patients of different ages and medical conditions. I am also familiar with various electronic medical record systems and medical coding procedures.
• 2. What motivated you to become an RN case manager?
  I have always had a passion for helping others and making a positive impact on their lives. As a registered nurse, I wanted to further improve patient outcomes by managing their care and facilitating a smooth transition from hospital to home. I am also drawn to the collaborative and problem-solving aspects of being an RN case manager.
• 3. How do you stay updated on healthcare regulations and industry updates?
  I regularly attend conferences, webinars, and workshops on healthcare policies and regulations. I am also a member of professional organizations such as the American Case Management Association, which provides access to relevant resources and updates in the field. I also make sure to keep up with industry news and updates through online sources and peer discussions.
• 4. How do you handle conflicts with colleagues or patients?
  I believe in open and respectful communication to resolve any conflicts. I always try to address issues directly and seek to understand the other person's perspective. I am also willing to compromise and find a solution that is mutually beneficial. For patient conflicts, I prioritize empathy and actively listen to their concerns to find a resolution.
• 5. How do you balance your workload as an RN case manager?
  Prioritization and time management are crucial in balancing the workload as an RN case manager. I start by assessing all the tasks and identifying the most urgent and critical ones. I also delegate tasks if possible, and I am always willing to seek help from my team if needed.

Behavioral Questions

• 6. Tell us about a time when you had to advocate for a patient's care.
  In one instance, a patient required a specialized procedure, but the insurance company denied the request. I contacted the insurance company to explain the medical necessity and provided supporting documentation from the physician. I also reached out to the hospital's patient advocacy team to support the case, and we were able to secure approval for the procedure.
• 7. Give an example of a particularly challenging case you managed and how you handled it.
  I had a patient with a complex medical history who was transitioning from the hospital to home care. The patient required multiple medications and had a complicated care plan. I set up a care conference with the patient, their family, and physicians to ensure everyone was on the same page. I also worked closely with the home health agency to ensure appropriate follow-up and support for the patient. The patient's condition improved, and they were discharged home successfully.
• 8. How do you handle non-adherent patients?
  I approach non-adherent patients with empathy and try to identify the barriers to their adherence. I also educate them on the importance of their care plan and the potential consequences of not following it. I involve the patient in creating a plan that is feasible and manageable for them. I also collaborate with other healthcare professionals, such as social workers or therapists, to address any underlying issues that may be causing non-adherence.
• 9. How do you maintain patient confidentiality in your role as an RN case manager?
  I strictly follow HIPAA regulations and have a thorough understanding of patient confidentiality and privacy laws. I ensure that all patient information is stored securely and shared only with authorized individuals. I also practice discretion when discussing patient cases in team meetings or with other healthcare professionals.
• 10. How do you handle a difficult conversation with a patient's family member?
  I handle difficult conversations with empathy and tact. I start by actively listening to understand their concerns and emotions. I also provide clear and honest explanations while maintaining a calm and professional demeanor. I encourage open communication and offer my support and resources to help them navigate the situation.

Situational Questions

• 11. How would you handle a disagreement with a physician regarding a patient's care plan?
  I would approach the physician and express my concerns respectfully and provide supporting evidence for my suggestions. I would also seek advice from my supervisor or consult with other healthcare professionals to find a compromise and reach a consensus on the best course of action for the patient.
• 12. What would you do if a patient's insurance denied coverage for a necessary medication?
  I would first review the insurance policy and medical necessity criteria. If the medication meets the criteria, I would initiate an appeal process and provide supporting documentation from the physician. I would also explore alternative options with the physician, such as finding a generic version or applying for patient assistance programs.
• 13. How would you handle a patient who refuses to follow their care plan?
  I would try to understand the reasons for non-compliance and address any concerns or barriers the patient may have. If necessary, I would involve other healthcare professionals, such as social workers or caregivers, to provide additional support. I would also educate the patient on the potential consequences of not following their care plan and the importance of their health and recovery.
• 14. What would you do if you suspected patient neglect or abuse during a home visit?
  I would follow the proper protocol and report my concerns immediately to my supervisor and appropriate authorities, such as Adult Protective Services or the police. I would also document my observations and any statements made by the patient or caregiver. I would prioritize the patient's safety and well-being above all else.
• 15. How would you handle a patient with conflicting diagnoses and treatment recommendations from different healthcare professionals?
  I would gather all the relevant information and consult with the patient's primary care physician first. If necessary, I would also reach out to the other healthcare professionals involved to discuss and find a resolution. I would prioritize the patient's best interest and advocate for the most effective and appropriate treatment plan.

Technical Questions

• 16. What is your experience with electronic medical record systems?
  I am proficient in various electronic medical record systems, including EPIC, Cerner, and Meditech. I have used these systems regularly to document patient information, review medical histories, and track care plans. I am also familiar with medical coding procedures for accurate and timely documentation.
• 17. How do you manage patient case load and documentation efficiently?
  I prioritize my tasks and utilize time management strategies. I also make sure to document patient information accurately and in a timely manner, as it is crucial for continuity of care and insurance purposes. I also seek assistance from my team if my case load becomes overwhelming.
• 18. What is your experience with care coordination and discharge planning?
  I have experience in care coordination and discharge planning for patients in both acute and community care settings. This includes collaborating with healthcare professionals, creating detailed care plans, and ensuring the transfer of necessary information for a smooth discharge process. I am also familiar with resources for post-discharge care, such as home health agencies and rehabilitation facilities.
• 19. How do you prioritize patient needs in a fast-paced environment?
  I assess patient needs based on urgency, severity, and medical necessity. I also regularly communicate with the healthcare team to ensure everyone is aware of any changes or critical issues. I also reassess patient needs as their condition evolves to ensure they receive the appropriate level of care and support.
• 20. What is your experience with utilization review and managing medical costs for patients?
  I have experience in utilization review and managing medical costs for patients through my role as an RN case manager. I am familiar with insurance policies and medical necessity criteria and work closely with physicians to ensure appropriate utilization of resources. I also collaborate with insurance companies and advocate for patients when necessary to ensure they receive the necessary care to support their recovery.