7 Key Hospital Case Manager Interview Questions to Ask

Inpatient case managers are vital members of the healthcare team. In addition to maintaining hospital flow and patient length-of-stay targets, they serve as important liaisons between patients and necessary resources. When hiring for this important role, asking thoughtful hospital case manager interview questions is essential for finding the right fit for your team.

To help ensure your interviews are optimized for the best hiring outcome, we’ve outlined seven key case management interview questions with tips for evaluating candidates’ answers. If you want to be sure you have the best candidate pool to choose from, developing a well-written job description goes a long way. You can also explore current hospital case manager job openings to learn what top qualities other organizations are looking for.

With resources like our free, downloadable hospital case manager candidate evaluation form (found below) you’re set with everything you need to guarantee a streamlined and beneficial hiring experience.

Hospital Case Manager Interview Questions and Answers

Effective hospital case managers have the clinical awareness needed to prioritize complex patient needs, while applying regulatory knowledge and communication skills to streamline care coordination. The job can be highly demanding and comes with a significant amount of pressure, particularly in acute settings. Here are seven interview questions for case managers that will help you determine who aligns best with your organization.

1. What qualities and experiences do you have that make you the best case manager for our team?

Set a conversational tone for your hospital case manager interview questions by first allowing candidates to speak to their qualifications and job readiness. Making the question more general can empower candidates who have a passion for case management but no direct work experience, revealing capabilities that influenced the decision to cross-train.

What to listen for:

• A strong record of clinical and patient advocacy experience
• Clearly articulated skills and qualities that would contribute to this specific role within the hospital setting (such as a passion for interprofessional collaboration)

Potential follow-up questions:

• Are you familiar with any particular electronic health record (EHR) systems, and do you feel confident about the heavy documentation requirement of this role?
• How would you encourage patient and family engagement with care plan logistics and goals?

2. What are the key factors you consider when developing a patient’s discharge plan?

A significant aspect of case management is quality discharge planning. It’s important to establish that this is a priority for your candidate early on within the interview questions. Case managers in hospital settings often work within strict length-of-stay targets and meeting those projections can affect a facility’s bottom line.

What to listen for:

• A clear understanding of discharge requirements (such as safe disposition considerations)
• Willingness to engage with community partners and resources to help optimize a patient’s discharge plan

Potential follow-up questions:

• What’s your method for addressing conflicts when there’s disagreement about the discharge plan?
• Can you highlight a specific experience where communication (good or bad) significantly impacted a patient’s discharge?

3. How comfortable are you with navigating regulatory requirements and insurance issues?

Understanding the intricacies of medical billing and regulatory requirements is essential for case managers to effectively advocate for the patient and progress care plans. For example, the Centers for Medicare and Medicaid Services (CMS) often has strict parameters and conditions of participation that define how participating facilities approach care. A quality hospital case manager works within those guidelines to protect both the patient and organization.

What to listen for:

• A thorough understanding of patient rights and HIPAA laws
• Knowledge of specific payment models (like the CMS TEAM initiative) and experience with insurance prior-authorizations

Potential follow-up questions:

• Can you tell me how you protect patient confidentiality while communicating on their behalf with necessary support systems and external resources?
• Has discharge planning ever been complicated by an insurance claim denial? How did you handle that situation?

4. How do you stay current with healthcare payer developments and regulatory changes?

Now that your previous case management interview questions have established that your candidate is familiar with current insurance and regulatory guidelines, it’s time to confirm their appreciation for healthcare’s constant evolution. You want a case manager who’s taking the initiative to stay up to date and informed of any developments that may affect their job duties.

What to listen for:

• A passion for continued learning and professional development
• Direct examples of expert-backed credible information sources, such as a regulatory newsletter or healthcare journal

Potential follow-up questions:

• What professional development opportunities have you engaged with in the last year?
• Are you case management certified, or do you plan on pursuing certification?

5. How would you help improve communication flow within our interdisciplinary team?

Communication is an essential skill for maintaining productive collaboration. Go beyond the minimum requirement and seek out truly motivated candidates by asking how the prospective hire plans to improve communication.

What to listen for:

• Appreciation for the value of teamwork within care coordination
• References to specific team members who they may work with on a routine basis and how they contribute to the effectiveness of the care manager role

Potential follow-up questions:

• How do you build trust and rapport with new team members?
• Tell me about a time when you and a team member disagreed on a care plan recommendation or decision?

6. Walk me through the resources that you find most valuable for patients with highly complex medical and social needs.

Advocating for patients (often with complicated needs) and connecting them with the necessary resources to help optimize and progress their care plan is another key function of a hospital case manager. Interview questions should verify the candidate’s awareness of available resources that may prove essential to helping your inpatient population.

What to listen for:

• Identification of appropriate patient follow-up access points for ensuring discharge success
• Familiarity with specific organizations and programs (ideally listed by name) that may assist with the particular needs often required by your patients

Potential follow-up questions:

• Have you ever experienced a situation where a patient had competing needs, complicating your ability to connect them with resources? How did you handle that issue?
• What’s your preferred method of outreach when contacting these services and care partners? Is one communication method more effective than others?

7. If a patient was ready for discharge but refused the plan that you and your team had worked hard to develop, how would you handle that issue?

One of your case manager interview questions should ask for consideration of a specific scenario. If the candidate hasn’t had this particular experience, ask them to walk you through their response if this were to occur. Insight into how they’d approach a tense situation like this one will conclude the interview with a clear depiction of how equipped the candidate is to handle the position’s stressors.

What to listen for:

• Specific de-escalation techniques that would help diffuse the situation, preventing further conflict
• A person-centered approach and respect for patient autonomy while addressing next steps

Potential follow-up questions:

• How would you encourage the patient to share their hesitation and the reasons behind the refusal?
• How can you help align patient expectations with hospital policies and procedures (or billing considerations)?

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