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Discussion

Where to find good Utilization Review Nurse Managers or Case Managers?

Hi Everyone,

I have a unique opportunity and am looking to find a really good utilization review nurse manager for a leading healthcare organization. It's a director of UM for a leading health care organization in Pennsylvania and provides for a sign on bonus and relocation.

I have followed some groups on LinkedIn, but am at a loss in connecting with a Nurse who has management experience and knows the ins and outs of Utilization Management/Review.

Are there any forums or online outlets that may be able to help me with my search?

I look forward to your replies!

Best,

Randy

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    Hi randy!

    I can't help you with the management portion but I am a um nurse. Basically, I go to 2 hospitals everyday and do chart reviews. We use milliman criteria to determine medical necessity. We are taking on more of a case management role currently, helping with discharge planning, making post discharge appointments for our patients and recommending resources that may be of benefit to our member population. When not at the hospital, I do work from home. I came from working in the hospital and it has been an interesting change, to see healthcare from a different prospective. I could be more challenged, but it works for now. Good luck with whatever you choose!

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    Randy,

    Email me please would be interested to here more [email protected]. I have appeal, concurrent, precert, and coding.

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