Interview for UR position

Been there,done that, ASN, RN · May 14, 2014

They are offering you an interview because of your clinical skills.

Are you familiar with the principles of managed care? Cram and jam anything and everything about Interqual.

You need to present your knowledge of the business side in the interview. You may be asked questions like...

How would you determine the medical necessity of an admission.

Good luck, feel free to PM me, I've been there , done that.

SummerGarden, BSN, MSN, RN · May 15, 2014

A similar question would be "How would you present a case that no longer qualifies for acute care stay to an MD advisor for review?" Basically, they would want to know if you can acutally talk to a doctor rather than just wait or take orders because you are intimidated by MDs. The kind of nurse that cannot influence MDs or others to do what is best for the patient (and the bottom line) is the type of UR nurse that is a waste of space and has no business working in UR or Case Management because he/she drives the costs of health care up. Good luck. :)

newbowen · May 17, 2014

Thank you! Googling Interqual now....

newbowen · May 17, 2014

Thanks MBARNBSN :-) Those are the questions I feel like I'll choke on because I don't have experience in the UR field. Based on the acute care experience I have we look at moving the patient to a non acute care setting based on insurance coverage and pt need (i.e., ASL, SNF, HH, etc). Is this what you were driving at? Appreciate the responses so far! :-)

SummerGarden, BSN, MSN, RN · May 18, 2014

Thanks MBARNBSN :-) Based on the acute care experience I have we look at moving the patient to a non acute care setting based on insurance coverage and pt need (i.e., ASL, SNF, HH, etc). Is this what you were driving at? Appreciate the responses so far! :-)

Yes. Also, if insurance cannot cover the cost, the patient will need to do so... In some settings MSWs deal with cases where the patient is 100% responsible for care in the next setting, but that does not negate your responsibility as a nurse to inform the IDT ASAP that the patient no longer needs acute care services. Good luck.

newbowen · May 28, 2014

So, I had the interview and I think it went well:-) Didn't really get the typical interview questions, although some were sprinkled in there. I got questions like "Tell me about a time when you had to deal with a difficult patient. How did you handle that?" I gave the answer and they spun the same question, "Now, tell us of a time when you had to deal with a difficult co-worker." Answered that and they spun it again, "Now, tell us of a time when you had to deal with a difficult doctor. He's angry because he doesn't understand why you are calling him for this information. How do you handle that?" Other questions included, "Tell us about a time when you attempted to handle a situation but you weren't able to do it on your own and had to get a supervisor involved.", "Tell us about a time when you were responsible for instituting change in your work area and how did you do it?"

That's all I can remember right off the top of my head. I'll let you all know if I get the job......keep those fingers crossed for me!

newbowen · May 28, 2014

I got a call today for a second interview...Yay!!! But I'm racked with nerves! Will this be all new questions or the same questions by different supervisors??? Help :-)

SummerGarden, BSN, MSN, RN · May 29, 2014

My second interviews for case management positons were usually similar to your first, since the first was a screening interview over the phone with a recruiter. My third interview (I guess similar to your second one) was bascially asking me if I want to job and how much the job pays. So good luck! :)

MissJLG · May 30, 2014

Hi Newbowen! I have a phone interview with Aetna for the same position! I am so nervous! This thread really helped answer some questions. Please let us know how the second interview goes. Thanks MBARNBSN and Been there, done that for the answers.

newbowen · Jun 3, 2014

MissJLG, the phone interview wasn't bad at all:-) They asked a little about my background and then spent a lot of time telling me about the position. The second interview (first in person interview) lasted about an hour. I was so nervous. I did a lot of research on the Aetna website just to get a feel for the company and what their core values were. I was able to work that into a few of my answers.

MBARNBSN - I'm hoping that this second interview feels a little more laid back. A friend of mine who works at Aetna said that the second in person interview is usually done with a manager and the director. They review the answers to my questions from the previous interview and if anything needs to be clarified, they'll ask in this interview. The interview is this Thursday so I'll keep you all posted.....fingers crossed for me please :-)

Rntr · Jun 21, 2014

How did your second interview go...