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babynurse1996

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  1. Utilization review nurse advice

    babynurse1996 replied to nursep2015's topic in Case Management
    Guess it depends on the person. I don't have burnout and like others, enjoy working remote.

  2. Utilization review nurse advice

    babynurse1996 replied to nursep2015's topic in Case Management
    Hi - I am new here and found your post. I have been an RN for over 20 years. I work as a UM Reviewer. It's definitely a specialty. Basically you learn the Health Plan criteria and systematically apply this knowledge to the medical records you are reviewing. Once your review is complete, you make a decision to approve, pend, deny, or send to the Medical Director(s) for further review. It is mostly straight-forward but of course there will always be out of the norm cases. Good luck to you!

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