I was a critical care nurse for years. I was so burnt out that l almost walked away from nursing. Your channel randomly popped up in my news feed a few months back. I applied for UR nurse WFH and l got the position. I absolutely love this job. I am currently in a BSN to MSN leadership and management program. I think I found my calling as a nurse
Omg! That’s amazing! I’m so happy for you! Girl I’m sure you was burnt out. It can be a lot. I’m happy you found some joy in UR! You will definitely keep up your critical thinking skills. I wish you success in your MSN leadership program ❤️
Not quite long I started investing. I'm very curious and need help on how to enhance and increase my returns. Any good investment tips would be appreciated
@@eadad4371 Alright so generally, investing requires higher knowledge. For this reason, It's important to have a solid support structure (financial consultant) to guide you through especially in asset picking. I operate with (REGINA LOUISE COLLARO) an investment advisor who partners with a licensed wealth management firm. For the record, the experience has been the best for my finance. She is quite popular for her services so you might have heard of her. She made me financially stable investing through her help, now I earn on a monthly basis through her passive income strategy...So I’ll advise you do get a good Investment advisor for yourself.
@@skoopqueen. That’s great , your investment advisor must be really good,I have seen testimonies of people using the help of investment advisors in making them more financial stable. Do you mind sharing more info on this person?..
@@eadad4371 look her up on the internet and leave her a message she's quite popular for her services as she was recently featured on cnn. She can work with anyone irrespective of where their located
@@skoopqueen. I have had the intentions of starting investing. But I always thought it was late and I think I need to stop procrastinating. I will definitely 🔍 Regina Louise Collaro and see what she can advise .Thanks a lot . This was of so much help to me .
What companies are hiring I have been looking for years and no one is hiring they keep saying i need 2 to 3 years of experience and im like i need to get experience to learn!!! 😢
Thank you so much for sharing your journey!! I have applied to countless different UR nurse jobs and not a single call back. I have asked a friend who is UR nurse but she has been mum., some gatekeeper or whatever her reason is but you you just helped me a lot with this video. God bless you!
Hey! I’m glad this video was helpful! If you have any more questions let me know. I don’t mind sharing because I would want the same for me. God bless you as well! 🥰
Thanks for the video. I'm a LVN and I was recently diagnosed with Cancer. I went through Chemo and now in Remission. I was told by 2 of my doctors not to return to floor nursing. I still need to work so this job would be perfect.
I’m sorry to hear about your diagnoses, but I am sooooo happy you are in remission! You need to find a remote position so you can work from home. Utilization would be perfect as well as case management. I hope you find what you are looking for! ❤️
Currently a MS/Tele Nurse looking to transition to case management, this video was so helpful in preparing me for my upcoming interview and lowering my anxiety. Basically, what I gather, is to be a good candidate for an UM/UR nurse you just have to be a strong nurse in general, I'll have to let my clinical background speak to that haha! But, really, thank you sooooo much for the amazing and informative video. Definitely subscribing :)
Thank you so much for your support! Wishing you the best on your interview. I’m glad this video was helpful. You will do great! You have the acute clinical experience now you can use your knowledge to improve patient outcomes post hospital. 💕
Hi! Just did a search in yt for UR nurse and your video came up. I'm looking to make a switch and UR has always been at the back of my mind.. I want to switch, because I want to move states... Trying to get all the pieces together! You have helped me with your video and I subscribed. God bless!
Hi!!! I’m glad this video has helped you! Yes! Come on over to UR! There are many opportunities! If I can answer any questions you may have, let me know! Thanks for your support!
Thank you so much for this video. Very helpful. I also have a degree in Informatics but I have not been able to secure a job yet. I recently found out about UR positions at my current job and have an interview scheduled for next week! I am excited and nervous but I hope I get it. Wish me luck!
Good luck on your interview!!!! Informatics jobs have been becoming more available in the recent years. Check out your IT department at your location. You’ll do great!
Great Morning! Thank you so much for the video. I have my second interview today for a UR Nurse Specialist position. I am looking to return to school for my masters. Do you mind recommending any schools that are well know for their informatics program?
Hi! Congrats!!!! I hope you get the position! Definitely let me know. I went to Grand Canyon University. It was an online program. The classes were 7 weeks long. I had a good experience there. The only complaint I’ve heard is finding a preceptor during COVID but if you join the informatics group on Facebook, you’ll definitely find preceptors on there. I hope this helps! 💗
Hey! I’m glad this was helpful for you! You are absolutely right! They do have this for Behavioral Health! From what I have experienced with Behavioral Health at my facility, they conduct phone calls for the reviews instead of through a computer system.
You are the bomb!!, GOOD FOR YOU!! I've messed around to much and never went to college just started working. Then got into healthcare and loved it. So started taking my rn prerequisites and worked as a CNA. But worked to much and slacked off classes. Then said I can still do lpn..... Well now I'm 50 and a CNA also a flight attendant at delta airlines. But really missing making it to LPN/RN.
I’m glad I was able to help! I don’t think a course is necessary. If you have hospital clinical experience, you will be able to learn the additional skills on the job.
Your presentation was quite informative. I have a few questions regarding the job description. Would a UR nurse need to be knowledgeable in CPT-ICD 9 coding, or, is the focus on extracting pertinent information that could prove to be cost effective for the insurance company, hospital and patient? Would this job entail identifying duplication of services and contacting the treating discipline to explore options? My background is ER, ICU, Infusion therapy and Home Health 15+ years. This sounds like the ideal job for me but I will quickly lose interest if this job is boring. However, if the duties require critical thinking, investigative skills and creative skills, I think I would love it. I would greatly appreciate it if you would respond. I am sure that there are many other nurses who would love your reply. Thanks again!
Hi hope all is well! With this job you will get education on CPT codes for inpatient and outpatient procedures according to Medicare guidelines. You will communicate often with the physicians and care managers on the plan of care for the patients and track avoidable days in the hospital. You will definitely use your critical thinking skills. It will allow you to stay updated with the most effective and evidence based practice interventions. Utilization involves a lot of detective work and proving cases to the insurance companies.
@@dopenursingish Lol, I didn't realize that you responded almost one year ago. Thanks. I am going to apply tonight and let you know how things work out. Thanks again. You are appreciated!
I enjoyed watching your video! I’ve been a UM nurse for awhile now, but I’m thinking of doing nursing informatics in the future. Can you provide more information on nursing informatics roles? Thanks again for sharing your insight on utilization management!
Hi! There are so many different roles as a informatics nurse such as analysts, educators, and EMR trainers. But I will be doing a video to describe the different roles as an informatics nurse. 😊
I can’t believe universities can’t get away with taking maybe 1,000 pre nursing majors and only have room for maybe 80 after 2 years! Nobody seems aware of that either!
Thank you so much! A lot of nurses who do prior auths work with insurance companies. I actually know a nurse who used to work from home with an insurance company doing prior auths. They normally get a list of procedures for patients from the doctor office coordinators for patients undergoing procedures requiring authorization for inpatient vs outpatient before the actual procedure. Or, another aspect is patients needing rehab and approved auths are needed based on the clinical. Thanks for the support! 💕
This is literally the direction my nursing career is going in. I started off as an ADN. I did med surg/Tele for a year and a half straight out of school and I became burnt out so fast it wasn’t funny. I began traveling at that point. The money was good and I loved it at first. But once Covid hit, I was in California and I was traumatized from the amount of deaths and unethical practices I was witnessing. I came back home and landed a job as an OR nurse. I’ve done that for a year and a half now and I’ve decided it wasn’t for me. I’m currently in enrolled in WGU’s RN to MSN (informatics) program. I’ve also just landed a clinical review job for an insurance company. I hope I’m making the right decision. Idk why I have this fear of stepping away from direct patient care.
Hi Jasmine! Omg we have almost the same nursing journey! It can be a little scary leaving bedside. But I can tell you that I don’t regret it. I can see how you got burned out. It is a lot! But I think that you will enjoy clinical review. You are still using your clinical skills but in a different way. Informatics is growing so much and in the recent years I have seen more and more opportunities for informatics and utilization.
Thank you so much for this information! I am in the same shoes as I feel a lot of nurses are as well, burnt out on bedside care... :( I have applied for a few UR jobs and fingers crossed I get one!
I hope this video provided some informative information for you! The advancement in UM nursing would be to move more into administrative positions such as manager, supervisor, and even director.
Currently a MS/Tele nurse. Been a ms/tele nurse for 3 years, looking to transition into UMR, but i cannot get an interview for some reason when i applied everywhere. lol. its frustrating. ;-(
Thank you so much for your video and sharing your journey. Congratulations on your success obtaining your MSN. I am an RN and I have a background in insurance and I worked for a hospital dealing with hospital billing. I am trying to leave the bedside but it’s been a challenge. Now I have a better understanding of this position and I feel this is definitely something I could do. Wishing you the best and thank you!
Hi! Thank you so much for the kind words! I’m glad you found this video helpful! You would be great for utilization!!!! Wishing you the best! If you have any questions I would be glad to answer!
I want to get away from bedside within the next year been thinking about telehealth triage nursing, case management, home health care been at bedside as a ob maternity nurse 17 year's tired need a change.
Hi! You have definitely put your time in at the bedside. There are many opportunities besides the bedside. It’ll be less demanding and better work life balance.
Thank you for this information. I have recently been looking into Utilization Review and Prior Authorization nursing. I’ve had a few jobs prior to nursing in healthcare such as being a pharmacy technician for 2 years and a registration representative for an urgent care for 2 years. Both job required me to speak with insurance companies. I also was a nurse tech on an orthopedic floor for 1 year. Once I graduated nursing school in 2020 I began my nursing career at a pediatric bridge hospital for 9 months and I have now been working as a operating room nurse for a year. Is this enough experience to apply to a Utilization Review/ Prior Authorization nurse job?
Oh yesssss! You can definitely apply! If you are able to pick important clinical information from a chart that makes that patient acute or non acute, you got it!!!
Thank you so much for sharing your experience. I have been working as a bedside nurse in critical care for 2 yrs with travel experience as well and began experiencing burnout a year ago. I recently began doing my own research to find an option away from the traditional bedside role and felt overwhelmed by the endless options available because I had no idea what many of these jobs required. This information has been very helpful in my search and i appreciate the insight!
Hi I’m glad you found this video helpful! I was afraid of experiencing burnout as well. I would see a lot of the older nurses unhappy coming to work. I’m glad that nursing has so many different opportunities that we can venture into! If you have any questions, let me know. Wishing you the best in your nursing journey.
Interesting video. Nurses need to understand that you do not need to have an MSN to become a utilization review nurse. I have been a UR nurse for a year, love it. Prior to that I was a case manager for 14 years ( this is great experience to transition to UR)
I work 5 days a week. 3 office days and 2 work from home days. No weekends but if you’re on call day falls on the weekend or holiday then you’ll just have to be near your phone or computer to answer questions of the help desk can’t figure out the issue. Definitely good work and home life balance.
@@dopenursingish Thank you. Do you know anyone who works as a UAS assessor remote hybrid ( a couple days work tele, a couple days go to client homes )? Sounds interesting but not sure thanks!
Thank you so much for video, I am a UR Pharmacy Technician and I work on the same platform with the UR nurse team, I am going to school to become a nurse, but may I ask you does UR nurse get paid the same as hospital nurse?
I’m glad you found this video helpful! It’s good that you are already working with the UR team. The hospital where I currently work normally pays the UR nurse more than the floor nurse but it also depends on years of experience, education, and certifications.
Thank you for the info. I am currently searching for an at home case manager position but I do have experience in UR. So, are you still working from home?
Hi! You should definitely be able to find at home case manager positions as well as UR. I’m currently not working from home. I go into the office 5 days a week. I’m enjoying going in at the moment but I can see working from home in the future.
Hi yah, you said you have no idea about UR nrsing but you were hired. May i ask if they let you underwent a training for it before you did d job? Also, How much is the rate for this UR nurse? No need for a master's degree?
Hi! Yes most utilization jobs will hire you with at least 3 years of acute care clinical experience. They prefer you to have UR experience but it’s not required. No, you don’t need a master’s degree to do UR, most institutions require BSN.
Do you have any utilization experience? If not, you should try to find a hospital utilization position first. I know that Horizon normally had openings.
I just graduated RN school in the beginning of 2022, I've worked for a little over a year now and I'm so desperately wanting to work from home. I still don't feel super strong in my skills due to being new and all so would this be something for me to hold off on applying for? I'm also a licensed occupational therapy assistant and worked PRN hours at a nursing home for around 3 1/2 years. I just wouldn't want to fail at a new job if I don't catch on quick ya know? Any help would be appreciated, thank you!!
Hi! Congratulations on graduating nursing school! I think it’s better to get more clinical experience before doing utilization. If you have a broad range of acute care nursing experience such as med surg, tele, and others, it would make you stand out more to employers. You will also understand more of the rationale of what is acute vs non acute and important clinical information that is needed for the insurance companies. I hope this helps!
I have been an RN for three years now! I know it doesn’t seem very long but working through the pandemic burnt me out pretty quickly. I have BSN and I have been thinking about becoming a UR nurse but I don’t have much knowledge of experience in the field. Do you recommend obtaining an MSN in nursing informatics or just simply applying and hoping for the best?
Hey!! You definitely don’t need to obtain your MSN to get a UR position. I would just apply. If you are looking to go the route of nursing informatics then getting your MSN will be beneficial. There are a lot of opportunities opening up for nursing informatics.
Thank you dope i want to do UR nurse but i dont have any experience here in the US i am about to resign for my job as psych nurse i am 2 months only here working but my mental stress for this job is killing me.could i have a chance to get that UR Nurse job even i dont have experience at all and what website adress i can check for UR nurse Job.and they are giving orientation for that before you do you work?
Hi! It’s not impossible to find a UR without experience but employers like for nurses to have clinical experience because it allows you to better understand the treatment plan. You can do a google search and many UR jobs will be available. Also if you go on to the websites like Cerner or Epic. You’ll find jobs there. Also, check the insurance company websites like Horizon, Aetna, Cigna. They are always hiring UR nurses. I hope this helps!
What kind of Hospital Backround? I am a NICU Nurse for 7 years, 6 months in Medicine ward, and 6 Months in SICU? Would my experience be enough to be hired as a UR nurse? Thank you.
Hi yes you your experience counts! I work with a utilization nurse now with a background in NICU. At my place of work we like to place the UR nurse on the floor in which he or she has experience in. But every place is different.
Hello, I am a nurse case manager with a degree in Psychology. I am an LPN and would like to know how I could become a utilization review manager? Do you have knowledge of Interqual ?
Hi! Hope all is well! Because you have a background in case management, it should be an easy transition into utilization. I personally don’t use interqual, but I know others who do. My facility uses MCG which is similar to interqual. Both use criteria guidelines to determine inpatient vs outpatient. All you need to do is apply. There are plenty of jobs online offering Utilization positions. In the interview, highlight your case management background, strong clinical skills, and the ability to choose imperative information that correlates with the guidelines. I hope this helps!
Hey! You should look into the insurance companies like Horizon, Aetna, Cigna. Also, if you type into google, remote Utilization review nurse jobs, many of them will pop up. I hope this helps.
Hmmm now that part I’m not sure of. But if you work at a hospital in UR they may reimburse you for your masters. I was a on a cardiac unit at my hospital when I obtained my masters and they gave tuition reimbursement.
I hope it went well! Let them know you have strong clinical skills, ability to search chart for important information, interventions for certain diagnosis, MCG guidelines knowledge, & strong communication skills!
It depends. I know some UR nurses and Nursing informatics nurses both making over 6 figures. There are more opportunities in nursing informatics and a huge potential for growth.
@@dopenursingish Utilization, I have my BSN have no idea wear to look, doing CM now not really liking it….not sure if it is the company or the role….talking on the phone all day pretty much….concurrent review seems more like what I may be interested in
Some institutions don’t require a bachelors degree. It depends on your place of work. Look for utilization jobs that only require an associate. It’s many out there!
Hey! No, you don’t need UR certification. If you have experience with acute care facilities, great clinical skills, and good understanding of plans of care, you will be fine!
Hey! I didn’t receive any training prior to accepting the position. All of my knowledge came from hands on training and I believe it has been great! Utilization consistently changes so I am always leading something new.
Hi! Yes definitely! There are many online programs that allow you to work full time and attend school. Grand Canyon University was a good experience for me.
I believe you can do the job. It may be challenging in the beginning but with time and willingness to learn, I believe you can do it. The key to utilization is knowing what clinical information is needed to build your review.
It’s best to get at least 2 years of acute care experience then start applying to Utilization Review jobs. Go on google and search utilization review jobs, utilization management jobs, UR nurse jobs and tons will pop up. They main thing is for you to be able to pick important information from a patients chart to prove the medical necessity for the hospital per MCG guidelines or whichever guideline the institution uses. I hope this helps!
@@dopenursingish where did you complete your msn informatics? I am hoping to go into informatics, UR, anything that is not patient care at this point in my 10 year career. May I ask what the salary range is as well? Thanks for your info and happy to subscribe!
@@nicoleagee7285 Hi! I completed my MSN at Grand Canyon University. The program was good! Since I’ve graduated they have changed the curriculum a bit but overall it was a good program. UR salaries can vary by state but in Jersey it’s around 85,000 then add education and experience and you can get 6 figures. Informatics with experience is well into the 6 figures. I hope this helps!
I want to become a UM nurse. I have 4 months experience as a new grad. But have over 7 years of experience with insurance. I want this job so bad and l’ve been applying for 2 months and still nothing. Any advice?
It may be difficult because you only have 4 months experience. Usually, 2 years of clinical experience is recommended. However, don’t give up because it is a benefit that you have experience working with the insurance companies. If you get a call back for an interview make sure you talk about your experience with the insurance companies and how it correlates with you clinical nursing.
Hi, no utilization isn’t the same as coding. Utilization focuses on the clinical to send to insurance companies as to where coding is more of the diagnosis, patient type and specific codes needed in order to finalize billing.
@@dopenursingish How can I get started , I was thinking of getting an interqual certificate, I've been a CCM for the past 5 years and want something that is not consumer facing
Most of the jobs I’ve seen available require a bachelors, however I do know a few nurses without it. If you work at a hospital without your bachelors and you have been grandfathered in, transferring to the UR department may not require you to have a bachelors.
I was a critical care nurse for years. I was so burnt out that l almost walked away from nursing. Your channel randomly popped up in my news feed a few months back. I applied for UR nurse WFH and l got the position. I absolutely love this job. I am currently in a BSN to MSN leadership and management program. I think I found my calling as a nurse
Omg! That’s amazing! I’m so happy for you! Girl I’m sure you was burnt out. It can be a lot. I’m happy you found some joy in UR! You will definitely keep up your critical thinking skills. I wish you success in your MSN leadership program ❤️
@@dopenursingish thank you
I love this for you! So happy for you 💗
Wow! I am having a hard time with only bedside experience as well
Look at God
Not quite long I started investing. I'm very curious and need help on how to enhance and increase my returns. Any good investment tips would be appreciated
@@eadad4371 Alright so generally, investing requires higher knowledge. For this reason, It's important to have a solid support structure (financial consultant) to guide you through especially in asset picking. I operate with (REGINA LOUISE COLLARO) an investment advisor who partners with a licensed wealth management firm. For the record, the experience has been the best for my finance. She is quite popular for her services so you might have heard of her.
She made me financially stable investing through her help, now I earn on a monthly basis through her passive income strategy...So I’ll advise you do get a good Investment advisor for yourself.
@@skoopqueen. That’s great , your investment advisor must be really good,I have seen testimonies of people using the help of investment advisors in making them more financial stable. Do you mind sharing more info on this person?..
@@eadad4371 look her up on the internet and leave her a message she's quite popular for her services as she was recently featured on cnn. She can work with anyone irrespective of where their located
@@skoopqueen. I have had the intentions of starting investing. But I always thought it was late and I think I need to stop procrastinating. I will definitely 🔍 Regina Louise Collaro and see what she can advise .Thanks a lot . This was of so much help to me .
Good to see a video on UR nursing. This is what I do and I love it
Thanks sis! A lot of people don’t know about utilization. I’m trying to let them know it’s more out there 🥰
What companies are hiring I have been looking for years and no one is hiring they keep saying i need 2 to 3 years of experience and im like i need to get experience to learn!!! 😢
I’m a ER UR nurse and I love it.
That’s great! It definitely stays interesting!!
Yes!!! Nursing informatics and getting your NP in that as well!! That’s great! More video on that!
Thanks!!! I will definitely do more videos 🥰
Thank you for this video!!! This is what I want to do! About to take my NCLEX PN in a few weeks. Thank you for sharing.
I’m glad this was helpful! Good luck! I’m sure you’ll do well!!!
Thank you so much for sharing your journey!! I have applied to countless different UR nurse jobs and not a single call back. I have asked a friend who is UR nurse but she has been mum., some gatekeeper or whatever her reason is but you you just helped me a lot with this video. God bless you!
Hey! I’m glad this video was helpful! If you have any more questions let me know. I don’t mind sharing because I would want the same for me. God bless you as well! 🥰
Thanks for the video. I'm a LVN and I was recently diagnosed with Cancer. I went through Chemo and now in Remission. I was told by 2 of my doctors not to return to floor nursing. I still need to work so this job would be perfect.
I’m sorry to hear about your diagnoses, but I am sooooo happy you are in remission! You need to find a remote position so you can work from home. Utilization would be perfect as well as case management. I hope you find what you are looking for! ❤️
7:37 hope things worked out for you
Thank you for this, I'm currently looking for UR job, you gave me encouragement and empowerment
You will find one! Check all the insurance companies ( horizon, Aetna, Cigna, etc) and your local hospitals.
Currently a MS/Tele Nurse looking to transition to case management, this video was so helpful in preparing me for my upcoming interview and lowering my anxiety. Basically, what I gather, is to be a good candidate for an UM/UR nurse you just have to be a strong nurse in general, I'll have to let my clinical background speak to that haha! But, really, thank you sooooo much for the amazing and informative video. Definitely subscribing :)
Thank you so much for your support! Wishing you the best on your interview. I’m glad this video was helpful. You will do great! You have the acute clinical experience now you can use your knowledge to improve patient outcomes post hospital. 💕
Chil that's how most of them do! There's more to come Peach! Exactly why wr as women, rather a wife or not, we must look out for our own interest!
thank you for your information, I have worked as a UR nurse reviewer as a LPN now Iam a RN BSN, your information so helpful
Hey! I’m glad this video was helpful! Let me know if you have more questions! 😊
Blessings pon blessings ya journey ma. Word.
Thank you! 💕
I’m having my second interview tomorrow for a medical review nurse position, thanks for the info! 🙏🤞
Hi! I hope this you got the position!!!!!!!
Very informative. Thank you, Ish.
Thank you so much for this! I am currently looking to get into UR Nursing, and this was super helpful
I’m glad this video was helpful for you! If you have any questions, let me know!
Hi! Just did a search in yt for UR nurse and your video came up. I'm looking to make a switch and UR has always been at the back of my mind.. I want to switch, because I want to move states... Trying to get all the pieces together! You have helped me with your video and I subscribed. God bless!
Hi!!! I’m glad this video has helped you! Yes! Come on over to UR! There are many opportunities! If I can answer any questions you may have, let me know! Thanks for your support!
@@dopenursingish Thanks so much!
Thank you so much for this video. Very helpful. I also have a degree in Informatics but I have not been able to secure a job yet. I recently found out about UR positions at my current job and have an interview scheduled for next week! I am excited and nervous but I hope I get it. Wish me luck!
Good luck on your interview!!!! Informatics jobs have been becoming more available in the recent years. Check out your IT department at your location. You’ll do great!
Thank you for this video ❤
I hope you found it helpful! 😊
Great example of never giving up!
Thank you! 😊
You are amazing! I love your enthusiasm for learning and development. Thank you for sharing this informative video.
Thank you! I’m glad you enjoyed it!
Great Morning! Thank you so much for the video. I have my second interview today for a UR Nurse Specialist position. I am looking to return to school for my masters. Do you mind recommending any schools that are well know for their informatics program?
Hi! Congrats!!!! I hope you get the position! Definitely let me know. I went to Grand Canyon University. It was an online program. The classes were 7 weeks long. I had a good experience there. The only complaint I’ve heard is finding a preceptor during COVID but if you join the informatics group on Facebook, you’ll definitely find preceptors on there. I hope this helps! 💗
FYI. A masters degree is not required for all UR positions
I know this was for nurses, but I know they provide this job for Behavioral Health professionals as well and this was helpful for me too!
Hey! I’m glad this was helpful for you! You are absolutely right! They do have this for Behavioral Health! From what I have experienced with Behavioral Health at my facility, they conduct phone calls for the reviews instead of through a computer system.
You are the bomb!!, GOOD FOR YOU!!
I've messed around to much and never went to college just started working.
Then got into healthcare and loved it. So started taking my rn prerequisites and worked as a CNA. But worked to much and slacked off classes. Then said I can still do lpn..... Well now I'm 50 and a CNA also a flight attendant at delta airlines. But really missing making it to LPN/RN.
Aww thank you!!! You know what, it’s never too late! However, I give you much props for doing both, CNA and flight attendant! You’re always on the go!
You can still go back to school beloved it's never too late.
Great great video! ❤
Thank you! I’m glad you enjoyed! 💕
Thank you
Very informative!! Thanks. Do you recommend taking a UR course?
I’m glad I was able to help! I don’t think a course is necessary. If you have hospital clinical experience, you will be able to learn the additional skills on the job.
Thank you ma .it was great video
Thank you for the support!
Very interesting video. Thanks for sharing ☺️😌. I am a nursing educator on utube. I subscribed. Good luck
Thank you for supporting! I’m about to check your channel out now! Good luck to you as well! 🥰
Your presentation was quite informative. I have a few questions regarding the job description. Would a UR nurse need to be knowledgeable in CPT-ICD 9 coding, or, is the focus on extracting pertinent information that could prove to be cost effective for the insurance company, hospital and patient? Would this job entail identifying duplication of services and contacting the treating discipline to explore options? My background is ER, ICU, Infusion therapy and Home Health 15+ years. This sounds like the ideal job for me but I will quickly lose interest if this job is boring. However, if the duties require critical thinking, investigative skills and creative skills, I think I would love it.
I would greatly appreciate it if you would respond. I am sure that there are many other nurses who would love your reply. Thanks again!
Hi hope all is well! With this job you will get education on CPT codes for inpatient and outpatient procedures according to Medicare guidelines. You will communicate often with the physicians and care managers on the plan of care for the patients and track avoidable days in the hospital. You will definitely use your critical thinking skills. It will allow you to stay updated with the most effective and evidence based practice interventions. Utilization involves a lot of detective work and proving cases to the insurance companies.
@@dopenursingish Lol, I didn't realize that you responded almost one year ago. Thanks. I am going to apply tonight and let you know how things work out. Thanks again. You are appreciated!
I enjoyed watching your video! I’ve been a UM nurse for awhile now, but I’m thinking of doing nursing informatics in the future. Can you provide more information on nursing informatics roles? Thanks again for sharing your insight on utilization management!
Hi! There are so many different roles as a informatics nurse such as analysts, educators, and EMR trainers. But I will be doing a video to describe the different roles as an informatics nurse. 😊
Whats the pay like?
@@nyamoitaratemo9130 The pay is pretty good. It depends on your state and company but you can get 6 figures!
@@dopenursingish can you help me with my resume! Lol
Shared with my mom!! Thanks
I hope it’s helpful for her! 😊
I can’t believe universities can’t get away with taking maybe 1,000 pre nursing majors and only have room for maybe 80 after 2 years! Nobody seems aware of that either!
It’s so crazy how that happens! Since then they have changed the regulations. So now they are allowing incoming freshman directly into the program.
Nice video ❤
Thank you! 🥰
Great video thank you! For prior auth nursing what does that entail exactly?
CONGRATULATIONS on your degree and growth!
Subscribed!
Thank you so much! A lot of nurses who do prior auths work with insurance companies. I actually know a nurse who used to work from home with an insurance company doing prior auths. They normally get a list of procedures for patients from the doctor office coordinators for patients undergoing procedures requiring authorization for inpatient vs outpatient before the actual procedure. Or, another aspect is patients needing rehab and approved auths are needed based on the clinical. Thanks for the support! 💕
@@dopenursingish thanks so much for the info your channel is helpful!!!
This is literally the direction my nursing career is going in. I started off as an ADN. I did med surg/Tele for a year and a half straight out of school and I became burnt out so fast it wasn’t funny. I began traveling at that point. The money was good and I loved it at first. But once Covid hit, I was in California and I was traumatized from the amount of deaths and unethical practices I was witnessing. I came back home and landed a job as an OR nurse. I’ve done that for a year and a half now and I’ve decided it wasn’t for me. I’m currently in enrolled in WGU’s RN to MSN (informatics) program. I’ve also just landed a clinical review job for an insurance company. I hope I’m making the right decision. Idk why I have this fear of stepping away from direct patient care.
Hi Jasmine! Omg we have almost the same nursing journey! It can be a little scary leaving bedside. But I can tell you that I don’t regret it. I can see how you got burned out. It is a lot! But I think that you will enjoy clinical review. You are still using your clinical skills but in a different way. Informatics is growing so much and in the recent years I have seen more and more opportunities for informatics and utilization.
Thank you so much for this information! I am in the same shoes as I feel a lot of nurses are as well, burnt out on bedside care... :( I have applied for a few UR jobs and fingers crossed I get one!
Hi! I’m glad this video was helpful! I hope you land your UR position soon!
Very informative. Thank you. Do you know what the advancement for UM nurses are?
I hope this video provided some informative information for you! The advancement in UM nursing would be to move more into administrative positions such as manager, supervisor, and even director.
the video i needed to see!!!
I’m glad it helped! ❤️
Currently a MS/Tele nurse. Been a ms/tele nurse for 3 years, looking to transition into UMR, but i cannot get an interview for some reason when i applied everywhere. lol. its frustrating. ;-(
Aww I understand your frustration! Have tried applying to Horizon? They are always hiring and have the option to work from home.
Aww I understand your frustration! Have you tried applying to Horizon? They are always hiring.
@@dopenursingish since you mentioned it, I did apply yesterday.
Thank you so much for your video and sharing your journey. Congratulations on your success obtaining your MSN. I am an RN and I have a background in insurance and I worked for a hospital dealing with hospital billing. I am trying to leave the bedside but it’s been a challenge. Now I have a better understanding of this position and I feel this is definitely something I could do. Wishing you the best and thank you!
Hi! Thank you so much for the kind words! I’m glad you found this video helpful! You would be great for utilization!!!! Wishing you the best! If you have any questions I would be glad to answer!
I want to get away from bedside within the next year been thinking about telehealth triage nursing, case management, home health care been at bedside as a ob maternity nurse 17 year's tired need a change.
Hi! You have definitely put your time in at the bedside. There are many opportunities besides the bedside. It’ll be less demanding and better work life balance.
🙌🏽 thank you for this !
I hope I was able to help!
Great video! Looking for additional income. Question: is there training given for this job?
Thanks! Most utilization jobs will hire you with at least 3 years of acute care experience.
@@dopenursingish perfect! I have 5 years exp! Thank you so much
Thank you for this information. I have recently been looking into Utilization Review and Prior Authorization nursing. I’ve had a few jobs prior to nursing in healthcare such as being a pharmacy technician for 2 years and a registration representative for an urgent care for 2 years. Both job required me to speak with insurance companies. I also was a nurse tech on an orthopedic floor for 1 year. Once I graduated nursing school in 2020 I began my nursing career at a pediatric bridge hospital for 9 months and I have now been working as a operating room nurse for a year. Is this enough experience to apply to a Utilization Review/ Prior Authorization nurse job?
Oh yesssss! You can definitely apply! If you are able to pick important clinical information from a chart that makes that patient acute or non acute, you got it!!!
Hi Court,
Can you talk a little bit about your role as an OR nurse? I would like to hear your pros and cons of this position. :)
Thank you so much for sharing your experience. I have been working as a bedside nurse in critical care for 2 yrs with travel experience as well and began experiencing burnout a year ago. I recently began doing my own research to find an option away from the traditional bedside role and felt overwhelmed by the endless options available because I had no idea what many of these jobs required. This information has been very helpful in my search and i appreciate the insight!
Hi I’m glad you found this video helpful! I was afraid of experiencing burnout as well. I would see a lot of the older nurses unhappy coming to work. I’m glad that nursing has so many different opportunities that we can venture into! If you have any questions, let me know. Wishing you the best in your nursing journey.
@@dopenursingish thank you!
Interesting video. Nurses need to understand that you do not need to have an MSN to become a utilization review nurse. I have been a UR nurse for a year, love it.
Prior to that I was a case manager for 14 years ( this is great experience to transition to UR)
Hey Tracy by chance can share what company? Or do you recommend a company?
@@peachesroyale. I work at my local community hospital. Many hospitals and insurance companies hire utilization review nurses
@@tracyalbino-daggett4032 I am currently a Health Coach with one of the majors but not liking talking on the phone all day any more
@@peachesroyale totally understand. That is why I left DC planning. I would investigate local hospitals
@@tracyalbino-daggett4032 ok, much thanks 😊
Has anyone ever heard of Marie peppers
What are the typical hours ? No weekends ? Thanks!
I work 5 days a week. 3 office days and 2 work from home days. No weekends but if you’re on call day falls on the weekend or holiday then you’ll just have to be near your phone or computer to answer questions of the help desk can’t figure out the issue. Definitely good work and home life balance.
@@dopenursingish Thank you.
Do you know anyone who works as a UAS assessor remote hybrid ( a couple days work tele, a couple days go to client homes )? Sounds interesting but not sure thanks!
Thank you!
Thank you so much for video, I am a UR Pharmacy Technician and I work on the same platform with the UR nurse team, I am going to school to become a nurse, but may I ask you does UR nurse get paid the same as hospital nurse?
I’m glad you found this video helpful! It’s good that you are already working with the UR team. The hospital where I currently work normally pays the UR nurse more than the floor nurse but it also depends on years of experience, education, and certifications.
Thank you for the info. I am currently searching for an at home case manager position but I do have experience in UR. So, are you still working from home?
Hi! You should definitely be able to find at home case manager positions as well as UR. I’m currently not working from home. I go into the office 5 days a week. I’m enjoying going in at the moment but I can see working from home in the future.
Hi yah, you said you have no idea about UR nrsing but you were hired. May i ask if they let you underwent a training for it before you did d job? Also, How much is the rate for this UR nurse? No need for a master's degree?
Hi! Yes most utilization jobs will hire you with at least 3 years of acute care clinical experience. They prefer you to have UR experience but it’s not required. No, you don’t need a master’s degree to do UR, most institutions require BSN.
Hi ya'll, i worked in snf for 2 yrs now, bt im burnt out. Cn i work as a ur nurse?
Yes just start applying! Some companies prefer hospital experience but not all! Start applying you can do it!
I don't know what is going on. But I have put in numerous applications to insurance companies, remote work and not get any callback.
Do you have any utilization experience? If not, you should try to find a hospital utilization position first. I know that Horizon normally had openings.
@@dopenursingish No I do not. But I am also speaking about even remote triage nurse positions.
I just graduated RN school in the beginning of 2022, I've worked for a little over a year now and I'm so desperately wanting to work from home. I still don't feel super strong in my skills due to being new and all so would this be something for me to hold off on applying for? I'm also a licensed occupational therapy assistant and worked PRN hours at a nursing home for around 3 1/2 years. I just wouldn't want to fail at a new job if I don't catch on quick ya know? Any help would be appreciated, thank you!!
Hi! Congratulations on graduating nursing school! I think it’s better to get more clinical experience before doing utilization. If you have a broad range of acute care nursing experience such as med surg, tele, and others, it would make you stand out more to employers. You will also understand more of the rationale of what is acute vs non acute and important clinical information that is needed for the insurance companies. I hope this helps!
I have been an RN for three years now! I know it doesn’t seem very long but working through the pandemic burnt me out pretty quickly. I have BSN and I have been thinking about becoming a UR nurse but I don’t have much knowledge of experience in the field. Do you recommend obtaining an MSN in nursing informatics or just simply applying and hoping for the best?
Hey!! You definitely don’t need to obtain your MSN to get a UR position. I would just apply. If you are looking to go the route of nursing informatics then getting your MSN will be beneficial. There are a lot of opportunities opening up for nursing informatics.
@@dopenursingish Okay! Thank you so much for taking the time to reply!
Did you ever apply for the job?
Do they send you any equipments to use ?
It depends on the company you work for. I know some companies provide the computers or laptops and others make you use what you have at home.
What about if you only have 3 years plus home health nurse experience
It might be a little difficult but it’s not impossible! Look into Horizon insurance company. They are always hiring for utilization nurses.
Thank you dope i want to do UR nurse but i dont have any experience here in the US i am about to resign for my job as psych nurse i am 2 months only here working but my mental stress for this job is killing me.could i have a chance to get that UR Nurse job even i dont have experience at all and what website adress i can check for UR nurse Job.and they are giving orientation for that before you do you work?
Hi! It’s not impossible to find a UR without experience but employers like for nurses to have clinical experience because it allows you to better understand the treatment plan. You can do a google search and many UR jobs will be available. Also if you go on to the websites like Cerner or Epic. You’ll find jobs there. Also, check the insurance company websites like Horizon, Aetna, Cigna. They are always hiring UR nurses. I hope this helps!
Did they give you any training before starting as UR nurse?
Once I got the job they provided training. It took me about 6 months to really get comfortable and remember all of the guidelines.
What kind of Hospital Backround?
I am a NICU Nurse for 7 years, 6 months in Medicine ward, and 6 Months in SICU? Would my experience be enough to be hired as a UR nurse? Thank you.
Hi yes you your experience counts! I work with a utilization nurse now with a background in NICU. At my place of work we like to place the UR nurse on the floor in which he or she has experience in. But every place is different.
Hello, I am a nurse case manager with a degree in Psychology. I am an LPN and would like to know how I could become a utilization review manager? Do you have knowledge of Interqual ?
Hi! Hope all is well! Because you have a background in case management, it should be an easy transition into utilization. I personally don’t use interqual, but I know others who do. My facility uses MCG which is similar to interqual. Both use criteria guidelines to determine inpatient vs outpatient. All you need to do is apply. There are plenty of jobs online offering Utilization positions. In the interview, highlight your case management background, strong clinical skills, and the ability to choose imperative information that correlates with the guidelines. I hope this helps!
Can u suggest my some of remote jobs for utilization review nurse?
Hey! You should look into the insurance companies like Horizon, Aetna, Cigna. Also, if you type into google, remote Utilization review nurse jobs, many of them will pop up. I hope this helps.
Will companies that UR nurses work for offer tuition reimbursement for a masters in nursing informatics?
Hmmm now that part I’m not sure of. But if you work at a hospital in UR they may reimburse you for your masters. I was a on a cardiac unit at my hospital when I obtained my masters and they gave tuition reimbursement.
What system do you use
The EMR we use is Cerner and the guidelines we use for utilization is MCG.
I have an interview coming up, can you offer interview tips?
I hope it went well! Let them know you have strong clinical skills, ability to search chart for important information, interventions for certain diagnosis, MCG guidelines knowledge, & strong communication skills!
Curious what is the salary range for this position?
Hey it depends on the state but in New Jersey you can make 6 figures.
Which pays better? Utilization Review Nurse or Nursing Informatics?
It depends. I know some UR nurses and Nursing informatics nurses both making over 6 figures. There are more opportunities in nursing informatics and a huge potential for growth.
@@dopenursingish can you point me in the right direction, so I can apply
@@peachesroyale Hi which position are you looking into? Utilization or informatics???
@@dopenursingish Utilization, I have my BSN have no idea wear to look, doing CM now not really liking it….not sure if it is the company or the role….talking on the phone all day pretty much….concurrent review seems more like what I may be interested in
Most LVNs don't have a bachelors degree so if that's a requirement how are they hired?
Some institutions don’t require a bachelors degree. It depends on your place of work. Look for utilization jobs that only require an associate. It’s many out there!
Do I need a UR certification? I saw a course online for $100 not sure if I should take it.
Hey! No, you don’t need UR certification. If you have experience with acute care facilities, great clinical skills, and good understanding of plans of care, you will be fine!
Did you get good training??
Hey! I didn’t receive any training prior to accepting the position. All of my knowledge came from hands on training and I believe it has been great! Utilization consistently changes so I am always leading something new.
Can UR nurses with BSN earn their masters degree in informatics at the same time?
Hi! Yes definitely! There are many online programs that allow you to work full time and attend school. Grand Canyon University was a good experience for me.
Can a Lpn be a utilization nurse?
You sure can!
Hi, how many years did you need to work with patient care before applying to be a UR nurse ?
Hi! Most jobs require at least 2-3 years of acute care experience. I had 5 years before applying.
@@dopenursingish did you work other areas other than cardiac?
Hello 👋🏽 can a LPN work as an Utilization Nurse?
Hi!! Yes! I have seen LPNs work in utilization roles.
Do you think a nurse with only primary care experience can do this job? We mainly do prior authorizations on medications in my office.
I believe you can do the job. It may be challenging in the beginning but with time and willingness to learn, I believe you can do it. The key to utilization is knowing what clinical information is needed to build your review.
Is one year of med-surg experience for enough in order to become a UR nurse? Or case management nurse ?
It depends on the company you apply for. If you interview well and prove you have strong clinical skills, you can do it. It never hurts to try ❤️
How can I be a UM nurse? bed side is not for me. I am new grad RN
It’s best to get at least 2 years of acute care experience then start applying to Utilization Review jobs. Go on google and search utilization review jobs, utilization management jobs, UR nurse jobs and tons will pop up. They main thing is for you to be able to pick important information from a patients chart to prove the medical necessity for the hospital per MCG guidelines or whichever guideline the institution uses. I hope this helps!
@@dopenursingish where did you complete your msn informatics? I am hoping to go into informatics, UR, anything that is not patient care at this point in my 10 year career. May I ask what the salary range is as well? Thanks for your info and happy to subscribe!
@@nicoleagee7285 Hi! I completed my MSN at Grand Canyon University. The program was good! Since I’ve graduated they have changed the curriculum a bit but overall it was a good program. UR salaries can vary by state but in Jersey it’s around 85,000 then add education and experience and you can get 6 figures. Informatics with experience is well into the 6 figures. I hope this helps!
I want to become a UM nurse. I have 4 months experience as a new grad. But have over 7 years of experience with insurance. I want this job so bad and l’ve been applying for 2 months and still nothing. Any advice?
It may be difficult because you only have 4 months experience. Usually, 2 years of clinical experience is recommended. However, don’t give up because it is a benefit that you have experience working with the insurance companies. If you get a call back for an interview make sure you talk about your experience with the insurance companies and how it correlates with you clinical nursing.
Is UR the same as coding?
Hi, no utilization isn’t the same as coding. Utilization focuses on the clinical to send to insurance companies as to where coding is more of the diagnosis, patient type and specific codes needed in order to finalize billing.
@@dopenursingish thank you so much for clarifying that!
Can you make 100,000 a year as a UR nurse , currently a CCM
Hi! Yes, you can definitely make a 100,000 salary with utilization.
@@dopenursingish How can I get started , I was thinking of getting an interqual certificate, I've been a CCM for the past 5 years and want something that is not consumer facing
Anyone took certification
I haven’t but I know many Utilization nurses who haven’t and isn’t required.
Do you have an email address where I can ask you a few questions?
Hi! Yes! Dopenursingllc@gmail.com
Can you be a LVN and do UN?
Hi! Yes I have seen companies hire LVNs for utilization review positions. 😊
sounds like a lot. hmmmm??
It’s very interesting!
Do you have to have a bachelors degree to work in UR
Most of the jobs I’ve seen available require a bachelors, however I do know a few nurses without it. If you work at a hospital without your bachelors and you have been grandfathered in, transferring to the UR department may not require you to have a bachelors.
Hello Ishana, please I need your help. I have an interview coming up. can i have your email so i can text you at the back to help me. Thanks
Elizabeth I hope I was able to help out and I hope your interview went well!
@@dopenursingish Thanks so much. I didn’t get the job, but today i just got an offer on another job as a UM. So excited. Your videos are the best.🤗