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

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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?

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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....:)

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Specializes in Hospice.

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

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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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