Utilization review, are other companies better than this?

Specialties Case Management

Published

Specializes in Peds, anesthia, burns, ICU, insurance.

Hello. Looking for any other utilization nurses out there who may have a lead on good quality companies.

 I'm a nurse with over 20 years of experience  in many different clinical fields. I am also a seasoned experienced utilization reviewer. 

 I have excellent ratings within my company, I'm a top performer, have a 0 miss deadline score, and near perfect quality reviews. Not to toot my own horn but I'm the top of the tree when it comes to this comes to this role.

 My issue is that while I love my very very large company in general, the utilization management section within it is a disaster. It is one issue after another. Management is often misleading, and mismanaging on a regular basis.

 The biggest thing is definitely workload. I understand that being in a salary position you're always gonna work a little more than 40 hours, but I am compensated well and have always just put up with it. But now it's getting worse and worse.

 It is now a daily routine to work over a good 2 plus hours and find many many others within my work group doing the same. Workloads are exploding and poor technology choices have been made which make our jobs even more complex and time consuming than they are to begin with.

 I never mind staying over here and there to do my part, I always go the extra mile, and do whatever is necessary to meet all of my deadlines and to meet the needs of the people whose cases I service.

 But I'm kind of done with working a 50 to 60 hour week every week and getting paid for 40. Done working 3 hours extra every Friday night.

 It can be hard to tell what the environment in another company really is, and how things really work. I'm hoping someone out there in the utilization review world is working for a decent company who actually respects  their nurses personal time and has their crap together.

Of anyone has a lead on a major insurer with excellent compensation and remote positions for IP concurrent review- that also is a well oiled machine instead of a dumpster fire - I would definitely be interested to hear that such a place exists.

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Specializes in Utilization Review.

my job may still be hiring...but I'm in Houston

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Specializes in Telemetry.

Hi Blucat, were you ever able to find a good company? I'm looking to transition from my care mgmt position to U.R./U.M. What you described does not sound pleasant at all and gives me anxiety.

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Specializes in Remote Ready Nursing Skills/RPM/HEDIS/Care Manager.

Utilization Review Remote jobs; Hello, It sounds like you really have some great experience!   I teach your-101 and assist nurses in landing remote jobs.  My nurses love their Remote Jobs with Humana, CIGNA, Elevance, and United Health Care. My job placement assistance and teaching are reserved for nurses in our courses.  I would say that CIGNA Utilization Review Remote Jobs have some of the BEST Benefits packages I have seen in the nation.  Just go to the company's main site and apply.  Make sure you have a nice crisp resume all tailored to the jobs you want to land.  Best wishes!  

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RemoteNurseJobs said:

Utilization Review Remote jobs; Hello, It sounds like you really have some great experience!   I teach your-101 and assist nurses in landing remote jobs.  My nurses love their Remote Jobs with Humana, CIGNA, Elevance, and United Health Care. My job placement assistance and teaching are reserved for nurses in our courses.  I would say that CIGNA Utilization Review Remote Jobs have some of the BEST Benefits packages I have seen in the nation.  Just go to the company's main site and apply.  Make sure you have a nice crisp resume all tailored to the jobs you want to land.  Best wishes! 

Hi, I have been working as a floor nurse in a SNF/nursing home and I'm considering a remote nursing job. I have messaged a couple nurses here too, and so for a utilization review nurse, when applying online do I have to make sure it's within the state I live in because of my nursing license? Or do the companies you mentioned,  hire remote work nurses no matter where you live?

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Specializes in ICU.

I think some companies don't care where you live.  What you have to find out is if they will train you online, or if you will need to be onsite.  I just started doing this work, and the beginning was a disaster, they were not ready to train me, but started me onboard anyway.  What I am seeing is there is more work than can be done in one shift, and I am reluctant to work over, because that situation only gets worse.  If you can work uninterrupted and get some good solid training, I think its a great job.

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