How to Become a Utilization Review/Utilization Management Nurse

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  • Опубліковано 25 лис 2024

КОМЕНТАРІ • 88

  • @remotenursefern
    @remotenursefern  Рік тому +6

    Thanks for stopping by to watch our career guide for remote Utilization Review and Management nursing! Feel free to drop a question about remote nursing in the comments :) We would really appreciate if you gave us a thumbs up on this content ❤

  • @melissapoole8580
    @melissapoole8580 4 місяці тому +12

    I stumbled into UR/UM and it was the best decision ever. I started remote nursing in 2016 and haven't looked back

    • @HaDealio
      @HaDealio 4 місяці тому +1

      Is your company hiring lol

    • @remotenursefern
      @remotenursefern  4 місяці тому +1

      That’s so similar to how I got started - a happy stumble

    • @atimnile2401
      @atimnile2401 2 місяці тому +1

      What company did u apply for ?? All of them are asking for CM experience. I have 16 years of hospital & long term care experience. Any advice or strategies?? Thanks

  • @TessinHaugabrook
    @TessinHaugabrook 7 місяців тому +1

    just wonderful!! you did a fabulous job ! it was clear ,straight to the point and supportive! just loved it!! Thankyou so much you are Wonderful!!

  • @MariE-go7ol
    @MariE-go7ol 10 місяців тому +8

    I was a bedside acute and critical care nurse for 20 years. Past 7 years I am a case manager and became certified last year. I think I should be able to find a remote position. I do not want a pay cut though.

    • @panglingaow
      @panglingaow 3 місяці тому +1

      Hello I've been an LVN for 20 years and I barely got into case management last month and I work remote now I can't believe I wasted my my life being miserable in a hospital setting just for insurance benefits from the county

  • @mariaclifton818
    @mariaclifton818 Рік тому +19

    Big problem with companies wanting UR UM experience. I have been an ICU Nurse, House Superviser and taught Epic in the last 28 years however most companies still want experience.

    • @remotenursefern
      @remotenursefern  Рік тому

      It's a challenge for sure!

    • @pirateslife4me
      @pirateslife4me Рік тому +2

      Agree! My background is similar to yours, and UR was the first nursing job where my resume was kicked back...within a day!

    • @vincentkingsdale8334
      @vincentkingsdale8334 3 місяці тому

      Can someone please explain why UR jobs want primarily nurses, as opposed to doctors, physical/ occupational therapists, or any other clinician that bills for services? I see some docs and therapists have done it, but just curious as to why it is primarily nursing. Thanks

  • @itr0863
    @itr0863 9 місяців тому +6

    after 13 years of ER experience as an ER tech, i went to nursing school and passed my nclex last month. after being rejected from the ER i work at and another ER in the city, I'm feeling down but not out. I reflected over my career in patient care as a non RN obviously and stumbled upon your video. thank you so much, i have hope again. i am now looking at non beside RN jobs that dont require RN experience.

    • @remotenursefern
      @remotenursefern  9 місяців тому +3

      I'm sorry to hear about your rejection and have had a similar experience. You have a lot of valuable experience to share in a non-bedside role!

    • @itr0863
      @itr0863 9 місяців тому

      thank you so much for the reply! i just got a job a florida blue!@@remotenursefern

    • @shirleyjay1718
      @shirleyjay1718 4 місяці тому +1

      I’m sorry to hear about your experience. You can definitely get a job as a utilization management nurse. That was my first job right after finishing nursing school. Some UM positions are working from home if that’s something that you’re looking for. I recommend applying to as much as jobs as possible eventually, you’ll land one.
      Good luck on your job search .

    • @itr0863
      @itr0863 4 місяці тому +1

      @@shirleyjay1718 thank you so much Shirley! After my ER rejection I ended up getting a job on an open heart step down unit. I’m actually on my last week with my preceptor and I’ll be on my own next week. That’s so awesome you do Utilization management out of rn school. Even though I’m learning so much on my unit, my #1 goal is to get a UM position like you after hopefully 1-2 yrs experience. I would love to go remote if possible too. Any companies you recommend or to look out for in the future? Thank you so much.

    • @Unraveling22
      @Unraveling22 3 місяці тому

      @shirleyjay1718
      Hey, I’m graduating next week and was looking into working remote until I get my license what types of jobs did you apply for if u don’t mind sharing?

  • @theblondeone8426
    @theblondeone8426 Рік тому +3

    yes i have 9 yrs experience as a float nurse and have never been hired for this but my experience is perfect for it. its frustrating…

    • @remotenursefern
      @remotenursefern  Рік тому

      It really is a frustrating process when we're so used to getting almost any job we apply to as nurses.

  • @ronp3840
    @ronp3840 4 дні тому

    I have been an echo tech for 8 years at a hospital. Can I get the utilization review remote position job?

  • @0846752
    @0846752 11 місяців тому

    This was VERY helpful, looking to transition, this definitely helped me figure out where to start

  • @mildredrodriguez4415
    @mildredrodriguez4415 Місяць тому +1

    Which certifications?

  • @mildredrodriguez4415
    @mildredrodriguez4415 Місяць тому +1

    Please where to get the certification

  • @khollandrn02
    @khollandrn02 7 місяців тому +2

    Helpful video! Ty

  • @roxannenoriega5661
    @roxannenoriega5661 29 днів тому

    Do you offer guidance with resumes?

  • @DrineThePoet
    @DrineThePoet 9 місяців тому

    Great video subscribed thank you!❤

  • @leslievalenciano-lopez8887
    @leslievalenciano-lopez8887 9 місяців тому +1

    Do you have any videos showing how to to MCG Clinical Reviews? My new CM position uses MCG and I’m wanting some assistance. I know IQ, just learning MCG.

    • @remotenursefern
      @remotenursefern  7 місяців тому

      Ah I wish! I am not personally experienced in MCG but one of our freelance writers is. It's pretty buttoned down and proprietary, so we don't have the ability to share much.

  • @pattyg.4872
    @pattyg.4872 Рік тому +2

    Great video! Thanks! I’m looking for something part time… what are the chances?

    • @remotenursefern
      @remotenursefern  Рік тому

      You're welcome! Thanks for commenting ❤️ I wish part time was more prevalent, but there doesn't seem to be much motivation for corporations to offer part-time when they can meet their needs with a full time role. We see the most flexibility in hours offered with triage or data abstraction positions. Rarely will we see a pt ur/um though.

    • @pattyg.4872
      @pattyg.4872 Рік тому +1

      @@remotenursefern Good to know. I’ve been applying for triage Nurse as I have over 15 yrs Urgent Care experience. I’ve had to retire from Clinic Nursing due to adverse effects from the Pfizer vax. I’m hoping I can get something part time to do from home. Wish me luck! 🍀

    • @remotenursefern
      @remotenursefern  Рік тому +1

      @@pattyg.4872 Definitely check out triage roles with your UC experience! Included Health is actively recruiting and I believe they may still have a PT roles open.

    • @pattyg.4872
      @pattyg.4872 Рік тому

      Awesome!! Thank you!!!

  • @azul8203
    @azul8203 9 місяців тому

    It’s not only how I get this position, but most importantly the training or familiarity with InterQual, and Milliman Criteria. All employers are asking for experience with these two Criteria’s. If you don’t have it, employers won’t consider you for the job.

    • @remotenursefern
      @remotenursefern  9 місяців тому

      Keep an eye on our job board. We prioritize posting roles that do not require exp. In fact, CVS has been on a hiring spree for their UM consultant roles and many nurses without experience in our community have been receiving offers. www.nursefern.com for our free job board

  • @dreamer9127
    @dreamer9127 2 місяці тому

    Do you need an RN or can LPNs do UR/UM as well?

  • @SusanBeard-cz4pd
    @SusanBeard-cz4pd 2 місяці тому +1

    Is this available for LPN/LVNs?

  • @His_ChristieRose
    @His_ChristieRose Рік тому +1

    Thank you for always sharing your tips. Do you think case management experience can lead to CDI roles?

    • @remotenursefern
      @remotenursefern  Рік тому +1

      Hi! I know a few CMs who transitioned over - they did also have the desired clinical background. Your CM knowledge is helpful!

  • @nisteber
    @nisteber Місяць тому

    What if I was an assistant nurse manager on an oncology unit in California, then a PE teacher at an international school in Bangkok Thailand and now I want this job. Will they accept me ?? lol

  • @MariE-go7ol
    @MariE-go7ol 10 місяців тому

    Really appreciate all your info!

  • @amandaditirro97
    @amandaditirro97 4 місяці тому

    I’m not sure if this has been answered yet. I have ER and IR experience and took time off to have babies. Is it possible to find a remote role weather triage,UR/UM, CDI position after a break in work with an active license?

  • @kathibangham2176
    @kathibangham2176 Рік тому +1

    In your experience is there ever remote RN/NP jobs in women's health? I am an FNP but have worked in women's health in postpartum in this role as well as worked as an RN in women's health for many years. Thank you

    • @remotenursefern
      @remotenursefern  Рік тому

      Yes! We see roles specific to women's health, fertility, OBGYN, etc... some will place the specialty in the title but most unfortunately bury the preference in the job requirements and preferences. It can lead to a lot of digging in job posts to find one that really wants your specific experience. We call this out for roles that we post on the job board to help make it easier.

    • @kathibangham2176
      @kathibangham2176 Рік тому

      Thank you so much for your prompt reply. It was very helpful.
      😊

  • @taraspeaks6293
    @taraspeaks6293 Рік тому +1

    What would be the best organization for me to become certified? And I am a LPN .....

    • @remotenursefern
      @remotenursefern  Рік тому +1

      Hey! Thanks for dropping a question. If you aren't experienced in UR/UM, wait until you have th e necessary experience to go for certification. You can find two of the major UR/UM certs in our career guide -> nursefern.com/remote-utilization-review-and-management-nurse/

    • @taraspeaks6293
      @taraspeaks6293 Рік тому

      @remotenursefern thanks for your reply and very detailed link. I am a Case Manager and have my certification in CMCN. So this was very helpful 🙂

  • @Csdc20
    @Csdc20 7 місяців тому +2

    nurse fern can u help me find a job in this field?

    • @remotenursefern
      @remotenursefern  6 місяців тому

      Hey there! Keep an eye on our daily job board for opportunities nursefern.com

  • @lesliejerry3
    @lesliejerry3 9 місяців тому

    Hi there. Is this limited to USRN? Can i apply if i am residing outside the USA

    • @remotenursefern
      @remotenursefern  9 місяців тому

      The roles we share usually require US residency

  • @sv5263
    @sv5263 Рік тому +4

    Is this role available to RNs without Bachelor level degree?

    • @remotenursefern
      @remotenursefern  Рік тому +2

      Yep! You’ll see some roles require BSN but many simply will list it as a preference. If BSN is req we note it on our job board.

    • @JasmineG
      @JasmineG 5 місяців тому +1

      @@remotenursefern Centene hires LPNs & RNs remotely

  • @juliebosung7844
    @juliebosung7844 7 місяців тому

    Hello ,this Julie ,I am interested in utilization review nurse

    • @remotenursefern
      @remotenursefern  7 місяців тому

      Check out our daily job posts :) www.nursefern.com

  • @ianmaem
    @ianmaem 9 місяців тому

    I am a UR nurse from the Philippines under 3rd party. I will be transitioning to the US in the spring to work in an LTC. But I am interested to go back to UR nurse as a 2nd job.
    Also a single a mom. And I can definitely say that working remotely has allowed me the work-life balance I needed. I was able to breastfeed my baby until I send her to school years later while at this iob.Thank you for this information. Will definitely keep it for the later months

    • @samanthapryce2864
      @samanthapryce2864 9 місяців тому

      Hi! Can you share which company you worked for as a UR and what do you mean by 3rd party?
      I'm residing outside of the US

    • @remotenursefern
      @remotenursefern  9 місяців тому

      Glad you're here - I appreciate you sharing your experience. ❤️

    • @JasmineG
      @JasmineG 5 місяців тому

      Cognizant Nurse Jobs in the Phillipines. Centene Corporation (St. Louis, Missouri, USA) has nurses in the Phillipines work Utilization Review.

  • @amandahollifield3297
    @amandahollifield3297 Рік тому

    Thank you 🙏

    • @remotenursefern
      @remotenursefern  Рік тому

      You’re welcome! 🫶 I appreciate you commenting!

  • @SarahSmith-df7ny
    @SarahSmith-df7ny Рік тому

    I only have MDS nursing experience for over 5 years in health insurance. Do you think it’d be possible to still get a job?

    • @remotenursefern
      @remotenursefern  Рік тому +1

      We do! Sometimes we see a remote MDS situation, but your experience with managed care and regulatory guidelines are highly transferable to other areas.

    • @SarahSmith-df7ny
      @SarahSmith-df7ny Рік тому

      @@remotenursefernThanks so much! Is there anyway to inbox you further questions?

  • @gobabe2396
    @gobabe2396 11 місяців тому

    Can I get directly in touch with you?
    Do you provide a service outside the UA-cam informational?
    I’d love an opportunity to talk with you. Perhaps you could provide more personal support.
    I would be willing to compensate you if you have a fee for service.
    Please let me know
    Thank you.

    • @remotenursefern
      @remotenursefern  11 місяців тому +2

      Hi There! I don't currently do 1:1. Sometime in spring I'm open to bring back my resume review service that is for nurses who have utilized our template. Otherwise, I provide as much personal advice as I can in our FB group.

    • @donitawhite8111
      @donitawhite8111 6 місяців тому

      ​@@remotenursefernthis is what I need help with. I have been a utilization review nurse a total of 8 years between two different companies. My first UR job was on the patient side at an adolescent behavioral health care facility. My next job was immediately after at an insurance company. I worked from home for a few years and loved it. Unfortunately they made some changes, including closing down my department, and I was no longer happy there. Since then I have returned to the bedside but have been applying for numerous jobs at Cigna insurance company. I have even had nurses who work at Cigna give me pointers and I'm still not even getting an interview. I've been trying for years. According to the nurses who work at Cigna, they use software to scan resumes for key words and if yours doesn't contain said key words it rejects it. I have updated my resume several times and still nothing. I literally don't know what else to do.

  • @thabi1312
    @thabi1312 9 місяців тому

    Can nurses with RN license in India do work remotely?

    • @remotenursefern
      @remotenursefern  9 місяців тому

      Our account focuses on roles that requires US residence and licensing but I would look to see if major insurance companies in your country hire nurses

    • @akshaykumar-xx3bs
      @akshaykumar-xx3bs 7 місяців тому

      Waiting for the response

    • @simeonapajarillo6499
      @simeonapajarillo6499 2 місяці тому

      No. You need to be US RN license

  • @RosieUnderwood-om3ui
    @RosieUnderwood-om3ui 8 місяців тому

    Great video subscribed thank you!