transitioning to UR/chart review!

Getting a certification in utilization review/management or case management would help. Sometimes it's not required but preferred by employers.

It can be tough to get a QA/UR nurse jobs if you don't have direct experience. Some people used to be case managers first before they transitioned into UR. The similarity is both case managers and UR nurses have to determine the necessity of care. Case managers coordinate the care among different providers like OT, PT, speech, nursing, etc. UR nurses determine if these cares are necessary. Providers get paid if they can prove that their services were necessary for the patients. That's where UR nurses come in. They use different criteria to determine medical necessity.