Healthcare case managers have challenged whether or not they are properly classified as exempt from overtime pay requirements in a number of recent cases.  The answer to the question of whether a case manager is or is not exempt from overtime depends primarily on two issues: 

  1. whether they perform skilled nursing case that would bring them within the professional exemption.
  2. the degree of independent judgment and/or discretion they exercise in performing their duties.

For instance, Field Case Managers employed by Genex Services in California claimed that they were wrongly classified as exempt from overtime, because, even though they were RNs, they did not actually perform work that involved any skilled nursing skill or expertise. They claimed that their job duties included only administrative and clerical tasks.  This case was settled. Similarly, case managers working for Carestar in Ohio made similar claims that they had been wrongly misclassified as exempt from overtime. After a federal judge ruled that there was an issue for a jury to decide as to the nature of the employees' duties, a finding that would determine whether or not they were exempt, the case also settled.  

Most recently, case managers employed by Centene in Washington filed a class action lawsuit for unpaid overtime. Similar to the other case managers they claimed their actual job duties did not involve nursing skill or expertise or use of independent judgment or discretion:

As Case Managers, Plaintiff’s and the putative class members’ primary job duty was non-exempt work consisting of reviewing medicalauthorization requests submitted by healthcare providers against pre-determined guidelines and criteria for insurance coverage and payment purposes.

This case has just been filed. What unites all three is that the employers gain substantial economic and competitive advantage by evading overtime pay requirements. By overloading an employee with work and not paying overtime, an employer essentially gets an employee for free.

Lexington, Kentucky overtime lawyer Robert Abell helps employees and individuals recover the overtime they've earned but not been paid; contact him at 859-254-7076. 

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MP 09/27/2015 03:53 PM
I am an RN case manager for one of these companies, in another state. We do not, in fact are not permitted, to perform any skilled hands on care. We review records and basically steer members toward where and how to apply their benefits. 90% of our work is telephonic and clerical, entering notes to prove "productivity" (we are expected to enter at least 15 notes a day). We are assigned more cases than anyone can possibly keep up with, let alone "manage". It takes an entire day to enter complete notes on one new case open or follow up visit. ( we are required to make a face to face visit every 90 days, but again are merely collecting data for the medical record. ( ie; Have you gone to the doctor? what medicationas are you taking? etc.) No clinical nursing care, no nursing judgement required. We are classified as exempt, but we don't make independent decisions regarding the member's care. Just follow clear cut guidelines on when the member is to be called, seen, and whether they are "high" risk for re-hospitalization or use of resources. It feels more like wage theft to be paid a certain amount, told your job is 40 hours a week ( or in my case 24 hours, cause I am part time) then to be given 20 or thirty cases to open within a certain time frame on top of managing a full caseload.
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