How much bedside experience to do utilization review/case management?

Nurses General Nursing

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Hi everyone!

I had a nurse friend ask me recently how much experience do you need in bedside nursing before you can start doing utilization review/case management (for an insurance company for example). I told her I had no idea, but thought i'd ask in a post on here.

anyone know?

There are UR people who have no medical background at all. CM? Not sure, but looking on specific insurance company sites (if they have job info) may help....:)

Specializes in Hospice.

on average i think its a minimum of 2 to 3 years

Specializes in ED, ICU, MS/MT, PCU, CM, House Sup, Frontline mgr.
on average i think its a minimum of 2 to 3 years

Yes, this is what I have seen too! I have also seen some places require a minimum of 5 years of recent bedside experience of new CMs.

OP: Tell your friend to read job descriptions to get a better idea of the requirements in your area.:up:

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