Case Management/Utilization Review

Mijourney · Jul 11, 2008

Hi. I live in Sacramento, California and I have been an RN for over 24 years. Can someone please tell me how I can get a Case Management, Utilization Review or Discharge Planning job if I don't have experience in those areas? I have been an RN for over 24 years, but my experience is in OB/GYN and Pediatrics. I would apperciate any help I can get.
Thank You.......... [/quote
If any are in your area, try applying to an insurance company. That is where many nurses get their start in case management and utilization management. There are companies like United Health Group and Blue Cross Blue Shield that manage commercial and Medicaid populations where your knowledge and experience would especially come in handy. Best wishes.

Besito · Jul 11, 2008

Hi, I have tried, but know one will interview me because I don't have any Case Management experience. It is realy hard to find a job without the experience, even though I have been a nurse for such a long time. If you have any other ideas please let me know.

Thank You!!!!

Mijourney · Jul 11, 2008

Try getting your foot in the door with a UM position first, then graduate to CM. That's usually the normal course in an insurance company. If the insurance company does not work, try a hospital's UM department. In fact, if you are still working in the hospital, find out who is over UM there and offer your services. If need be, volunteer some time for experience, if you have the time. Finally, be patient with the insurance companies, it took me a long while to get hired into one. Review your resume and cover letter and make sure that they are as sharp as possible.

helpinghands, BSN, RN · Jul 11, 2008

Home health usually involves case management and you don't need case mgmt experience to get the job. I'm sure any agency would love to hire a nurse with 24 years experience! It could be a great way to get case mgmt experience that could open a lot of doors in the future. Good luck with your job search!

Besito · Jul 12, 2008

I have also tried home health. Without experience it is very hard to find a job. I really don't know what else to do.

Thank You!

nurcardiac5 · Jul 18, 2008

Hi, I just recently landed a Case Management position in the hospital I work for. Years of nursing experience is the requirement. I worked in telemetry, ICU & a home care nurse for 15yrs. This qualified me. It is a hard job, and its challenging. It was difficult for me though to go from bedside nursing to case management, but my boss & co workers were and are very supportive. If u are currently in the hospital, start there, or search the web (www.indeed.com)

Besito
Hi. I live in Sacramento, California and I have been an RN for over 24 years. Can someone please tell me how I can get a Case Management, Utilization Review or Discharge Planning job if I don't have experience in those areas? I have been an RN for over 24 years, but my experience is in OB/GYN and Pediatrics. I would apperciate any help I can get.
Thank You..........

kwilkinsturner · Jun 19, 2009

I have only been a nurse for 11 years and I didn't even apply for the job. The company called me. They found my resume online. I had no experience in Utilization Review. When I started, it was kind of confusing but it is so interesting once you get the hang of it. It's extremely informative when u start to make the phone calls. You learn so much about disease processes that you didn't know existed. You can all google utilization review jobs on the web. There is a really good company in California, Arizona and Missouri that will hire nurses without experience. Good Luck in you search!!!!!

tabster224 · Jul 23, 2009

I live in SoCal atm but plan on moving up north with the next few years. What company in California hires for UR with no experience, I would love to get into this field. I have worked as an LPN first, then an RN for 22 years on and off in home health care ( for the last 14 on and off Case Managing in home health, do they count that as CM for telephonic CM?) I worked as an RN for 3 years in the hospital, and then 7 years in a Doctors office doing sedation for colonoscopys (also helped out in the office when the docs MA's were off). Thanks for the info.

kwilkinsturner · Jul 25, 2009

The Company is called Magellan Health Services. They operate out of California, Phoenix, Missouri. check their website for any open positions: magellanhealth.com. They are a really good company.

Hope this helps you out. Good Luck!!!!!

tabster224 · Jul 25, 2009

That is a huge help!! Thanks so much!!

Off topic here, but I have a old account tabby224, I joined on that account back in 01 i think, I posted a couple post and forgot about the account until right before I made this account. I tried to post with the tabby224 account and it just brings me to the page that I can't post possibly because the admin has me blocked or whatever. When I click on the admin help button, I get a username/password pop up box. When I put the info in, it just keeps popping back up. Just wondering if anyone knows why I can't use that account. Thanks for the help!!

Judi RN · Mar 19, 2010

I would love to know how to break in to case mangement I have over 25 years of nursing experience most of it is in the ED. I also have been doing MDS for medicare for the past 15 years but unfortunately this doesn't pay well. If you were me and needed to get your foot in the door where would you turn to . Luckily I have a NJ/NY liscense so I can work in both states :idea: any ideas would help Thanks for any ideas