How to become a Utilization Review nurse (no experience needed)

#nurse #utilizationreview
Hi! This video has been long overdue! Are you as excited as I am to finally have this video? In this video, I share how you can become a Utilization review nurse without any experience. I share my tips and tricks to get your resume seen and certain skills that I think are very important to have to be successful in this nursing job role.
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[@LifeAsWendyRN]

🔴Membership and courses if you're interesting in working from home🔴 20% off services from theremotenurse theremotenurse.com/lifeaswendyrn

[@kt2666]

Seriously guys just apply anyway to these UR jobs. I applied to a hundred with only 2 years of bedside experience and I got it. I received so many rejection emails but I kept applying. I only received an interview invite with two insurance companies but eventually rejected by both. One of the companies later contacted me and gave me an offer on the spot once another position opened up. So overall it took me 5 months to get a UR position. So keep trying!!

[@itr0863]

is this the same as a Medical Review Nurse Analyst? i just passed my nclex but dont want to do bedside nursing after 13 years as an ER medic. i'm trying to educate myself on what is out there besides beside nursing. Thank you

[@LifeAsWendyRN]

You’d have to look at the job description. I’m unable to answer that

[@angelinarios6341]

👍

[@onwednesdayswewearpink2761]

I got my first job in UR over 10 years and have stayed in Case Management ever since. To get my first job I took a weekend prn UR job at the lowest paying hospital in my city. I ended up working about 3 days a week in a few month. It took about 6 months to feel competent. After 1 year of Part Time work I was able to manage to get a travel gig.again it was low paying compared to others , but I considered that kinda of like "paying my dues" and proving myself as a UR nurse and as a traveler. I now take nice paying gigs to places like Cali. I have taken MANY remote UR jobs. My last UR remote gig payed $55 an hour... which I consider excellent for working sitting up i bed in my jammies.

[@LifeAsWendyRN]

Thanks for sharing!

[@nonna617]

thank you. I am just starting UR after years at bedside ICU and I am really intimidated by the process.

[@nicb8723]

Thanks for posting that. It’s given me hope I can find that type of job in PT or PRN.

[@bernadettee.5464]

I knew for several years I wanted to work from home, & I prayed for something, I didn’t know what it would be. When I was ready to leave the bedside I knew I wanted to do CM. I worked hospice CM for a year (loved it but it wasn’t WFH), & by God’s grace I landed a job that has cross work as CM, some insurance & UM or UR. I wasn’t even looking for the job when my former nurse mentor recommended this job. I been working remotely for a year now & I love it. Some flexibility with work & home life. Yes, my former superior said remote/WFH nurses are called Pajama Nurses. 😂 I love it & thank my Lord for this blessing. I have so much more to learn & like that you’re still using critical thinking brain skills.😊 We’re still RNs taking care of patients or members.🤩

[@onwednesdayswewearpink2761]

@bernadettee.5464 God is Good, All the time

[@carloldham8863]

Great video!! As a nurse with 6.5 years of experience, with most of it being in inpatient psych and 2 years at a nursing home with zero background in case management or utilization review, I struggled to find a job in this field, but yet it was always a dream job of mine and I never gave up. I tried so many insurance companies and even local hospitals. After starting my search way back in July and unfortunately dozens of rejected applications later with only two interviews at all, I just recently finally nailed a remote job in prior authorization from home with Centene, which is another good insurance company with remote work that you forgot to mention btw :) at least with my experience, they really wanted someone with background in managed care and why I believe it took me so long to even get an interview. It was a challenging experience but definitely possible with hard work and perseverance. I start in a month and I seriously can't wait 😊 your videos have inspired me for sure to look beyond the bedside and never settle with being unhappy with your job.

[@LifeAsWendyRN]

I am very glad to hear you didn’t settle and kept looking for a job that would make you happy. Centene is definitely in my list for the next video I make. There are so many companies out here that I didn’t even know existed until recently. Thanks for sharing your success story and hope others see your story as well and get inspired. Good luck!

[@flamingoidk6147]

Congrats. Can you refer nurses? I have psych experience too

[@maloriew.8682]

Congrats!!! How's it going with them? Also, can you work from anywhere or do you have to work from a home office?

[@lifewithcriscell]

“never settle for a job that you are unhappy about,” this is so true 👍

[@mochababy2117]

What do you mean “managed care” like management?

[@deelopez4609]

You do not need RN license. I have several LVN’s in my department.

[@LifeAsWendyRN]

You are correct. LVN too

[@deelopez4609]

We are currently hiring LVN’s. I’m the manager of the department.

[@gloriamontoya1906]

@@deelopez4609 as an LVN Um ?

[@deelopez4609]

@@gloriamontoya1906 yes. Most UM positions I’ve held are typically LVN’s. I’m the manager of the department as an LVN. I have two RN’s under me because I’m more experienced in UM and their experience is mostly bedside nursing. I did years of bedside before I went into UM.

[@sweetrese6]

@@deelopez4609 Hi. What company & what’s the salary?

[@angielasloan377]

FYI you said a person has to be an RN to be a Utilization Review Nurse , well I am a UR nurse and just a LPN and before this I was doing chronic care management and before that I did clinical appeals .The even had a MA doing clinical appeals.

[@LifeAsWendyRN]

That’s correct. I make these videos based off my experience which is why I said RN but yes LVN also can be UR nurses. Think I clarified that in the comments as well.

[@TheFukkyahh]

LPN’s are also hired for this role ❤️

[@LifeAsWendyRN]

That is correct

[@mingoramirez7385]

How can i do that

[@jenniferakindojutimi]

I have been applying for UR nurse jobs, and it has been difficult. When applying for the bedside positions, the entire process would take about 1-3 months. It’s a little discouraging because I keep receiving emails stating I am no longer under consideration. I have five years of nursing experience, including two years of hospice case management. I have tailored my resume three times to fit the roles of UR, case manager, and nurse navigator. This video was helpful, and I will not give up. I will keep applying until something great comes along. Thank you, Wendy.

[@LifeAsWendyRN]

Yes, don’t get discouraged and keep applying 💕

[@winnie7414]

Did you get your UR position yet?

[@pepper72375]

do i need compact?

[@pickles9440]

As time goes by, and insurance becomes more involved, the nurse to patient ratio at the bedside continues to shrink in order to be able to pay all of these other ancillary people that insurance wants and requires to be involved. Not to mention all of the IT people. Leaves little money left over to pay for bedside nurses. Sad. As such I am looking for a job away from the bedside. It’s for suckers.

[@LifeAsWendyRN]

What kind of jobs have you been looking into?

[@mochababy2117]

Definitely a set up, I am ready to go!

[@toyagill949]

Thanks for your video, I have been a nurse for about 20 years and I keep applying constantly for URN & CM jobs WFM & InPt and because of no experience i those areas, I feel like I am missing out, I won’t give up, I will keep applying & interviewing & praying. I am a very hard worker and I know I would make a good addiction to any team, I just don’t know what I am doing wrong, I updated my resume & now i guess my next step is trying to take som UM/Case Management courses but some of these online places are asking for $900+ for education, would you recommend taking these courses that are provided online or wait for training on the job once hired? Thank you again for your video, it was very helpful.

[@LifeAsWendyRN]

Up to you. I didn’t have a certification or take a course but it may help you stand out.

[@toyagill949]

@@LifeAsWendyRN thx I accepted an offer yesterday!! Yay!!!! Woo hoo!!!!!

[@ChubbsandSadie1]

@@toyagill949how’s it going?

[@cassandrakoblitz6112]

where are you?@@toyagill949

[@rinadianeconcepcion3418]

Hello Wendy! Will we be able to get a job and work in the US as a Utilization Review Nurse? Currently residing in the Philippines with a US RN license.

[@LifeAsWendyRN]

You’d have to find a company who hires internationally. I do have a video talking about companies who hire international nurses. You’d have to look through my channel.

[@mexicanakinskywalker6762]

I just graduated my lvn program here in CA and I am going to try to get a remote position as a case manager or utilization review. I know it may be difficult and the odds are against me as a new grad with no experience, (although i do almost have a bachelors in pub health) I am still determined to land a role in hope that someone out there is willing to take a chance on me and offering me a position to grow. If anybdoy has any recommendations for me as far as companies hiring for these roles or any tips for applying, please let me know. Wish me luck.

[@LifeAsWendyRN]

Good luck! In the past I’ve seen that anthem hires new grad nurses for remote positions.

[@deelopez4609]

Look up Molina Healthcare. They’re in 15-18 states. They hire mostly LVN’s.

[@deelopez4609]

They are based out of California. I worked for them, but changed to another company that needed a manager. I took that position which was less demanding and better $!

[@mexicanakinskywalker6762]

@@deelopez4609 Thank you for the tip! were you working at molina as an lvn? and are you in california? did it take you a while to land a case management job? I am just beginning my hunt to find a cm job withouth any clinical experience. i have a bachelors degree in pub health, i think i have a decent shot at getting an entry level cm job i hope

[@deelopez4609]

@@mexicanakinskywalker6762 I was in California when I worked for them but it’s not necessary to live there. I started UM nursing in the late 90’s via a temp agency.

[@ssneed7881]

What is the difference between UR and Prior Authorization Nurse?

[@iheartgs400]

Thanks for the video Wendy this gives me the confidence I just recently passed my Nclex on 3/31 just in nick of time before next gen and already working with hmo company thus far and prefer working in non hospital setting.

[@LifeAsWendyRN]

I love this! Congratulations 🎉

[@iheartgs400]

@@LifeAsWendyRN just waiting for my license to be activated and then the hunt begins. Its encouraging to know that I don’t need to jump into the hospital which is frankly not my cup of tea.

[@ramansidhu5454]

@@iheartgs400hey! I hope u got ur desired job. Can u plz share your experience working in non hospital settings? With which company u started working, any recommendations plz!

[@jobeesssssssssssssss]

Hi newbie here.. just passed my NCLEX and got my license, I dont have bed side experience within the USA but I have experience outside the country, Im really interested in working as an utilization review nurse..

[@LifeAsWendyRN]

Congratulations!

[@rw8373]

I have two months off from my hospital job and I want to use this time to try to get into utilization review. I know you mentioned certifications as a way to make yourself more marketable. What certifications were you referring to specifically if I don't have any case management experience?

[@LifeAsWendyRN]

Usually these certifications are obtained by already working a minimum 2 years in the specialty

[@lifewithbella0807]

Search Marie Pepper's Utilization review course. She also has other remote job opportunities.

[@surgerystudio7654]

I’ve talked to nurses who feel guilty and ashamed of being a UR nurse because of the ethics of insurance companies. All have said they’re only doing it for the money because they need to be able to support their families. How do you feel about it?

[@LifeAsWendyRN]

I worked at a hospital and we didn’t deal directly with insurance companies, at least not in my role.

[@melscorner4598]

I was a critical care nurse for years. I was going to walk away from the bedside because I was burnt out. I decided to apply as a UR..l absolutely love my job. I also work from home. There are many opportunities for advancement in this field. I don't feel guilty or ashamed. When my nurse friends complained about their job..l always tell them there are other options in nursing that will bring relief to your mental health.

[@deelopez4609]

I’ve been in and out of UR for decades and I’ve never felt guilty! I advocate for the patients.

[@776alpha677beta]

I know this post is old but as a hospital UR RN im curious what they are guilty about. I dont think the person writing this understands the job. We work by communicating about patients needs. Even when we “go to the dark side” lol & have a job for an insurance company the job is about quality and criteria. We are obtaining the clinical information on the patient to assure quality care within regulated criteria. Making sure the patient is at the appropriate level of care. & preventing abuse of financial resources. There is zero shame or guilt in the career.

[@LifeAsWendyRN]

What’s one thing you learned from this video?

[@PriscillaDesiree]

To apply anyway and believe that my experience and skills are enough to be a great candidate and get the job! Also to network! I’m an introvert so this is something I have to be intentional about and it actually is working for my benefit as we speak! A few days ago, I ran into an old co-worker of mine and while we were catching up, she told me she’s working in UR and I was like no way, I’m looking into that too! So she said our former ANM from our unit is working in UR as well and just posted on her FB about open positions! So I reached out to her and now we’re getting the ball rolling in terms of applying. So I’m super grateful to have made those connections! Thank you so much for the video! I’ve been wanting to learn more about this topic, so this was great timing!

[@LifeAsWendyRN]

@@PriscillaDesiree yesss, networking helps a lot. Thanks for sharing your story. You just never know who may help you down the road. By the way, I loved watching your channel. I saw you haven’t posted in a while but I really enjoyed your content 💓

[@NursingConnection]

That utilization nursing is a thing lol. 😂 never heard of it

[@LifeAsWendyRN]

@@NursingConnection lol I didn’t know about it either until I applied for it

[@nonna617]

that its possible without prior experience! thank you.

[@mochababy2117]

What kind of hours are you working for the hospital and for remote work?

[@LifeAsWendyRN]

I was doing 07-1700, 4 10hr shifts M-TH

[@Cc_1862]

Hi. Can I work remotely even if I'm not in the US?

[@LifeAsWendyRN]

Depends on the company policy

[@Knowledge23231]

How to got this job please tell me

[@evolving3657]

Curious, because I'm working on getting my CRC (risk adjustment ) coding certification and would prefer a UR Nurse position instead of my current Transitional care nurse position.

[@LifeAsWendyRN]

Stay tuned 👀

[@proudmarinemomma827]

What’s involved with getting that certificate?

[@anapaiz8175]

This was a great video!! Do you have any insurance company recommendations ? Please!

[@LifeAsWendyRN]

Yea, just to make a few there’s Anthem now known as Elevance Health, CVS, Humana

[@tinawitt998]

I am working in Utilization Review. Could I email you privately with a question?

[@georgethecatcabrera7505]

Hi Wendy, great video. Do your company hires part-time. I have no experience in UR, but I have case management and 20 years of clinical experience.

[@LifeAsWendyRN]

It was a local hospital but no part time option.

[@NURSEPAULINERN]

Thanks for sharing this very interesting video.

[@Dexterosa]

Thank you!

[@angelawalker7582]

Can a Licensed Practical Nurse become a UR

[@LifeAsWendyRN]

Yes

[@angelawalker7582]

@@LifeAsWendyRN Thank you for replying. What is it I need to become one

[@DrineThePoet]

Thank you for sharing!

[@LifeAsWendyRN]

You’re welcome!

[@BenRite]

Can UR or case management jobs be applicable to African countries?

[@LifeWithLou85]

Probably Not

[@deelopez4609]

I’m not sure about Africa but we do have some employees in other countries. The problem would be having a US license. Unsure if Africa has UM.

[@LifeAsWendyRN]

Sorry, this is based off my experience in the USA

[@deelopez4609]

@@LifeAsWendyRN yeah. Mine, too. We just hired a nurse from the Philippines but he has a US nursing license

[@LifeAsWendyRN]

@@deelopez4609 thanks for sharing!

[@marleneoliveira13]

Where to start with no experience? How do you get coding experience without having to get a whole other degree in medical and billing

[@LifeAsWendyRN]

I had no coding experience and it wasn’t something I needed to do in my role.

[@onwednesdayswewearpink2761]

OnWednesdays WeWearPink 1 second ago I have been in UR for 10 years. My advice, are you at a hospital now ? Go the the Case Management Director and ask to speak with them in person. And tell that how much you would love to help them . Tell them how good you are at extracting details...yada yaa and ask if they will be hiring for ANYTHING even prn so you can help them out. People never want to do anything face to face anymore, so it is even more effective

[@missbeahaven1935]

I'm disabled so, my license is inactive, can I still do this?

[@LifeAsWendyRN]

Usually jobs want an active RN license

[@marhar5973]

How many cases do you have to complete a day or how do they measure productivity?

[@LifeAsWendyRN]

It was a new pogram/role for my facility so we had no specific number to complete