Hi! Great video. I have been a case manager for the last 5 yrs. This is what I wanted to focus since nursing school. I love what I do, and I do believe that this specialty is not for everyone. This position can be difficult and frustrating at times, because you are the middle person between nursing staff, medical staff, ancillary, family, community and all of these must focus on pt’s best interest. We are pts advocates. Social issues can be very challenging at times and one must work with social workers and family before we can safely discharge a pt. Case management is a whole process to make a safe dc plan and to assist someone to avoid a re hospitalization. Where I work I do dc planning and Utilization Reviews. I work in ICU and there are frequent times when I have to arrange transfers for higher level of care to tertiary centers. There is a lot of phone calls done and like any other dept. tons of documentation to do. My advice to anyone is follow your calling. Work where you know you will enjoy what you do, otherwise the job will make you miserable. In case management you must build relationships with lots of people in your work area and community. If you’re a people person, you’ll be a great fit!
Thank you for this video! Is deciding if patients meet medical necessity for care based completely on the tool or do you need to use clinical judgment also?
I prefer UR to DC Planning. Not nearly the stress. But I have found people are either good at it, or they are NEVER good at it no matter how long they stay in it
HELP! Please :) I hope you see this! I applied for a clinical denials nurse job (involving data abstraction) I have no experience in the remote world only 3 years ER. They sent me an online assessment as the first part of the interview, what can I do to prepare? No idea what Im walking into but really want the job!
OMG! Thanks for this video. You’ve given me courage to pursue this career. However, I don’t have any formal UR experience but I have 10 years of bedside nursing experience. Can you give any tips on how to apply for a UR position with no formal UR experience?
apply to every hospital in your area that has a UR job, FT , PT or PRN until you find someone who will take a chance on you. Also I am assuming you work in a hospital... walk the the UR Managers office and ask to speak with them
hello and thank you for this video i learned a lot , i was also on the bedside for 8 years and now next week i will be starting on my new jump of career out of the bedside... I'm a newbie on UR....any thoughts on workers compensation Utilization Review nurse? thanks again
As a newbie, I'm concerned about reviewing patient charts, results, and other medical records, simply because I lack the exposure. How challenging is this part going to be for someone who has little experience? Any tips you can share? Thanks as always for the contents!
Hello, Nice video. I have 10 years experience in Critical Care (ICU) and looking to transition into Utilization Review RN. I was recently called by recruiter for 3 month contract as Utilization Review RN and agreed to apply. I then went online to see all opportunities for UR and many are remote jobs. I am now highly motivated to get one of these remote jobs and keep my per-diem ICU (2 shifts month requirement). Many of these jobs I see prefer some combination of HCPCS, CPT, ICD-9, ICD-10, CMS coding experience. Is there a good starting point to all of this to enhance my resume that is lacking in coding experience? Thank You, C
Hi! Great video. I have been a case manager for the last 5 yrs. This is what I wanted to focus since nursing school. I love what I do, and I do believe that this specialty is not for everyone. This position can be difficult and frustrating at times, because you are the middle person between nursing staff, medical staff, ancillary, family, community and all of these must focus on pt’s best interest. We are pts advocates. Social issues can be very challenging at times and one must work with social workers and family before we can safely discharge a pt. Case management is a whole process to make a safe dc plan and to assist someone to avoid a re hospitalization. Where I work I do dc planning and Utilization Reviews. I work in ICU and there are frequent times when I have to arrange transfers for higher level of care to tertiary centers. There is a lot of phone calls done and like any other dept. tons of documentation to do. My advice to anyone is follow your calling. Work where you know you will enjoy what you do, otherwise the job will make you miserable. In case management you must build relationships with lots of people in your work area and community. If you’re a people person, you’ll be a great fit!
Thank you for sharing your insights. Recently left bedside to focus on this area myself and you answered a lot of my questions.
Appreciate this video. So helpful! Thank you!
Very interesting video. Thanks for sharing 😌. I am a nurse educator on utube. I subscribed. Good luck 😸🤞
Great explanation! Thank you.
Thank you for this video! Is deciding if patients meet medical necessity for care based completely on the tool or do you need to use clinical judgment also?
Very well explained. Thank you
Great content! Currently a bedside nurse...contemplating switching over to the business aspect. Do you think the pay is congruent?
Thank you for this insight brother appreciate it. How does Utilization nursing compare to medical nursing coding?
I prefer UR to DC Planning. Not nearly the stress. But I have found people are either good at it, or they are NEVER good at it no matter how long they stay in it
HELP! Please :) I hope you see this! I applied for a clinical denials nurse job (involving data abstraction) I have no experience in the remote world only 3 years ER. They sent me an online assessment as the first part of the interview, what can I do to prepare? No idea what Im walking into but really want the job!
I’ve applied for so many jobs. Praying I get a call back soon. I have almost 5 years of RN experience but no UR experience.
Where can you get the training?
OMG! Thanks for this video. You’ve given me courage to pursue this career. However, I don’t have any formal UR experience but I have 10 years of bedside nursing experience. Can you give any tips on how to apply for a UR position with no formal UR experience?
Rab Makz sure, I’ll put something up soon for you.
I am also interested. 😁
apply to every hospital in your area that has a UR job, FT , PT or PRN until you find someone who will take a chance on you. Also I am assuming you work in a hospital... walk the the UR Managers office and ask to speak with them
hello and thank you for this video i learned a lot , i was also on the bedside for 8 years and now next week i will be starting on my new jump of career out of the bedside... I'm a newbie on UR....any thoughts on workers compensation Utilization Review nurse? thanks again
I'd love to know how this turned out for you? I'm thinking about it myself!
Aguy! Kahilo ka uy!
As a newbie, I'm concerned about reviewing patient charts, results, and other medical records, simply because I lack the exposure. How challenging is this part going to be for someone who has little experience? Any tips you can share? Thanks as always for the contents!
It will be a easy transition. It seems daunting at first but trust me it isn’t. You will get the hang of it and feel confident in 3 months or less
@@SamQuintani Thanks, Sam. You help a lot. Keep it up
Are there LPN s working as Utilization Nurses.
Yes they are.
What is the name of the guideline tool you suggested enter qua, sorry did not understand.
It was Interqual...Milliman Care Guidelines (MCG) is another tool that is sometimes used...depends on the insurance company.
Interqual
Hi Sam. What is the difference between a utilization review nurse and hospital RN case manager?
Good question I will make a video on this topic this week
@@SamQuintani Thanks Sama
Hello, Nice video. I have 10 years experience in Critical Care (ICU) and looking to transition into Utilization Review RN. I was recently called by recruiter for 3 month contract as Utilization Review RN and agreed to apply. I then went online to see all opportunities for UR and many are remote jobs. I am now highly motivated to get one of these remote jobs and keep my per-diem ICU (2 shifts month requirement). Many of these jobs I see prefer some combination of HCPCS, CPT, ICD-9, ICD-10, CMS coding experience. Is there a good starting point to all of this to enhance my resume that is lacking in coding experience?
Thank You, C
Hi Carl! Did you find an answer? Was also wondering same!
been in UR for 10 years..you will pick up what you need to know