Tips on getting a job in utilization review/utilization management

[Sbates20]

Hi! I'm an RN with 6 years of telemetry inpatient experience. I have also worked in inpatient rehab, and home health prn. I charge as needed, and precept new nurses frequently. I also float to a busy observation unit which focuses on getting patients in and out as quickly as possible. I've always worked nights on telemetry. I just got married, and my husband works normal hours, Monday through Friday. With my schedule I hardly see him. My unit has been very challenging lately, we have a higher census than normal, the patients are more acute than they should be for this unit, we are extremely understaffed. Every day that I am off, I have multiple people (staffing coordinator, unit coordinator, unit director) calling me asking me to pick up. I have heard through the grapevine the one or both of the managers are stepping down. Many nurses are leaving because of all of the chaos. I have been ready to get off of nights for a long time, but I don't really want to switch to days on my current unit to deal with more stress/chaos, while taking a pay cut. I know that I am burned out and need a change, asap. I have always been interested in patient care coordination or utilization management or utilization review. I feel that both would be something I would enjoy and would be good at. I have applied to multiple positions, even interviewed for one, but did not get the job. Does anyone have any tips that would help me get into this area of nursing? Any interview or resume tips, or even classes or certifications that I could do to make up for lack of experience in this area? Any help is greatly appreciated! Desperate over here.

[Libby1987]

Since you're new to this site, here is a link to the case management forum, under te above specialties tab..

https://allnurses.com/case-management-nursing/

[HouTx, BSN, MSN, EdD]

Certified Case Managers are in high demand in my part of the country. You may want to look into this.

[rearviewmirror, BSN, RN]

I work at TPA, in my limited opinion, CM and UM are vastly different at least in insurance, non-hospital setting (in hospital CM would do everything including UM part). Since you mentioned UM, I take it that you mean as in people who review clinicals and review for medical necessity; also personally I think working for insurance UM is better than hospital; they seem over-loaded at all times.

What did you say or do during the interview?

[psychnurse127]

I worked for an insurance company as a UR nurse and I felt very overwhelmed and overworked. Everything was about productivity and was all about quantity vs quality. Makes sense because the more cases we completed, the more money the insurance company would make. However, I'm sure hospital UR is also very difficult but I can only speak for insurance UR. I was hired with 3 years of floor nurse experience with no special certification or classes.