Non-bedside nursing: Utilization Review Registered Nurse

#registerednurse #nursing #utilizationreviewnurse
Hi! I am currently working as a Utilization Review Registered Nurse. In this video, I share what it is I do as a UR nurse. It is a nursing job beyond the bedside. I work at a desk and do not provide direct patient care. i do talk to patients over the telephone in order to help coordinate their care with third party vendors.
Nonetheless, I want you to know that there are nursing positions beyond the bedside. Working as a hospital nurse is not the only thing you can do as a nurse.
Social Media:
Instagram: Life as Wendy RN
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Thank you for watching and subscribing 😊

[@Bettysmiles]

That's what I love about nursing! It's so broad and so flexible!

[@lindasolomon6140]

It's so sweet of you to encourage nurses to find their passion in nursing. Beautiful you!

[@LifeAsWendyRN]

Thank you Linda! There’s a place for all of us in nursing. No reason to feel stuck 💕

[@4EVABLESSED7]

This sounds like a great job!!! I am just starting my nursing journey as I am currently in LPN school. Once I get my LPN/RN experience, I may look into this. However, I am thinking about becoming a Family Nurse Practitioner one day too! Thank you for sharing.

[@LifeAsWendyRN]

thank you for watching!!

[@Bettysmiles]

I just love working 3 days though, I don't know how I would feel about working mon-fri again.

[@luv2model2007]

Monday-Thursday

[@Karicacolli]

So helpful! Thank you bc I had no idea. I’m an OR nurse and I love it but it’s just not suitable for my current season in life. Homeschooling and opting out of daycare. I’ve found a per diem RN review so I wanted to see what it was before applying. Thank you

[@pamelab424]

I appreciate your video. You definitely spoke exactly what I’m feeling. I’ve been applying and it’s been a little disheartening but I will keep applying. Feeling stuck definitely but I trust God has a plan. Thanks again…current Mother Baby RN

[@LifeAsWendyRN]

Thanks for watching! Sending you all the positive vibes

[@alvinaurelio6189]

Saw this video and it brightened my day!!! I been doing direct pt care for 17 years. Right now I been doing dialysis nursing...and I am burned out. Saw a Nurse Reviewer position online earlier today and immediately applied . Hope I get it the position!!!

[@LifeAsWendyRN]

Good luck!

[@laurag5401]

Did you get the job?

[@LifeAsWendyRN]

Helllooo! Thanks for watching 💓 Do you have a non-bedside job that you currently work in? Share with us down below so that we can all learn about the different opportunities for nurses😊

[@nicamike2459]

Thank you so much. I’m currently leaving bedside nursing. I have interviews coming up for care coordinator and UR nurse. 🙏🏽

[@LifeAsWendyRN]

Good luck! Hope you get the job

[@sarahthomas9296]

Can you show me your resume or an example of one for someone who's going from bedside to nursing that is interested in utilization review/prior authorization?

[@pushprajsingh1166]

Hey I'm going to start a software project on UR.Can you help me understanding this job in a more detailed format...Thanks in advance :)

[@katerinabruner2123]

Thank you so much for this video! I subscribed :) Do you have tips on the application process? I’ve been applying to remote positions but I Believe that I’m being screened out. Was there something during the interview that they said why they brought you in? I’m just trying to figure out if it’s because of the lack of experience and utilization review and or case management. I’ve been a clinical RN BSN for 8 years

[@LifeAsWendyRN]

Katerina Bruner you could be right. Usually if they do not see case management or UR experience they’ll screen it out. Plus, sometimes it’s not even being reviewed by a person but by a robot who finds certain words that stand out. I had case management experience in primary care prior to becoming a UR RN so I believe that helped. Thanks so much for watching and subscribing!

[@kimberlycockram1894]

I’m a hospital case manager and I worked home health. If you’ve ever worked home health than you have case management experience.

[@MahasSaham79]

Most of the utilization review etc. Positions want experience or extra certifications. Do you have any recommendations as to how to get a UR or Case management position from bedside?

[@LifeAsWendyRN]

Nurse Judy I did not have UR experience nor do I have any certifications in CM. Now I know every place is different but most importantly you need to put yourself out there and apply for these positions that interest you. Some jobs will say they “prefer” experience and there are even some places that will help you get certified once you are working for them. My best advice is to just apply and put yourself out there 😊

[@dieksvantriest8269]

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[@afarro20]

Thank you for the video. I've been interested in utilization review for sometime and went into case management to help gain helpful experience for this. I currently work 4 10hour shifts and I love it. I want to make the transition to working from home with the same schedule. May I ask which company you work for that offers this schedule from.home.

[@captainawvius]

Thanks for the video! Do you need to be certified as a UR RN?

[@LifeAsWendyRN]

I was not

[@carlhammill5774]

I want to continue working as Per-Diem ICU nurse on weekends (2 shifts month requirement) and add remote full-time or part-time Utilization Review RN. If you were in my situation how would you start that process? Thank you, Carl

[@LifeAsWendyRN]

Carl Hammill you should try looking into your hospital system to see if there are any UR positions open. It would be a great way to get experience and will help to get UR positions that are remote.

[@guitarnerd1022]

Hi!! I’ve been an OR nurse for 2.5 years and looking to transition into being a UR nurse. Would having a CPC Certification for coding and billing help this career path as well? Thanks so much!

[@LifeAsWendyRN]

I didn’t have any extra certification but in my role we didn’t do coding and billing. I know there are some UR positions that having coding Cert would be beneficial

[@valeriedavila1800]

Hi Wendy! Are you required to also explain/communicate to patients whether they have been approved/denied coverage on claims?

[@LifeAsWendyRN]

Hi Valerie! In my role I didn’t deal with any insurance companies but with third party administrators. For unapproved claims we did not let the patient know directly but I’m assuming they got a notification letter.

[@lionlily0829]

Hi would you say utilization review is different than prior authorization/nurse reviewer? I was a bedside nurse and recently took a prior authorization job. During the interview the manger did say it was call center styled. I had no idea what I was getting myself into. My home set up is 2 computer screens plus a laptop. It is a lot to learn. I'm trying to be positive and think of how I can use my experience to do something else possible UM. I don't like the call center style at all.

[@474fsde]

Hello. Are you still at this job? I’m curious…. 😊

[@pennycsingh5427]

I have been applying over a year for non bedside nursing jobs. No luck what so ever.

[@carlhammill5774]

Are you in meetings alot? That was main reason I left my initial job in business to work in nursing. Now I am ready to transition back to non-bedside care position but want job that just allows me to work and not sitting in meetings constantly :)

[@LifeAsWendyRN]

I am definitely in more meetings than I used to be when I was providing direct pt care. I feel like I do more telephone conference calls though than actual in person meetings.

[@joannlam2473]

Is this a lot different from being a nurse case management? I'm interested in both and would love your input!

[@LifeAsWendyRN]

Case management is when ur managing care of group of patients but for UR u can use that skill for UR.

[@foreverme51]

Can you do this job as an entry level job. Meaning I have my BSN but no experience.

[@LifeAsWendyRN]

Sarah Scott most of these jobs prefer experience but doesn’t hurt to try and apply.

[@mariaschool7281]

Hello I just have a quick question do you work from home or in a hospital... And how do you like your job now compared to bed side...

[@LifeAsWendyRN]

maria school it’s a hospital. I do like the office job better than the bedside.

[@johnsonlillie2668]

Is this area opened to ADN-RNs with med-surg exp. only. Where is the training or experience for a UR position acquired from for nurses with no background in that area?

[@LifeAsWendyRN]

Experience isn’t always necessary since training would be on the job.

[@user-nr1vv8lj4s]

Can you do a video how to get a UR or case management job.Reality is even after 5 years of bedside nursing it’s difficult to land a UR or case management job. Is anyone else having hard time? Without prior UR or case management or even clinic experience it’s been difficult to get a job.

[@LifeAsWendyRN]

Yes, I’ve made that video already. It’s on my channel

[@robinigbinoba4504]

Hey Wendy, how many years of clinical bedside experience does one need in order to become a UR nurse?

[@LifeAsWendyRN]

Robin Igbinoba I had 5 years of bedside experience and 3 of primary care/case management. Usually for UR positions they may prefer both bedside and case management experience. But please don’t think you may not qualify, go ahead and apply you just never know what opportunity is waiting for you out there 😊

[@youyoua988]

What kind of career advancement does this job prepare you for ? I’m debating whether I want to keep bedside or something else but then I ask about if what else I could pursue with this kind of experience

[@LifeAsWendyRN]

Working in this role, you do get experience in case management/care coordination and in certain cases coding that can help you get other jobs that require those skills.

[@mireyaorosco9736]

HELP! Please :) I hope you see this! I applied for a clinical denials nurse job (involving data abstraction) I have no experience in the remote world only 3 years ER. They sent me an online assessment as the first part of the interview, what can I do to prepare? No idea what Im walking into but really want the job!

[@LifeAsWendyRN]

Good luck! For UR I didn’t do an online assessment so I wouldn’t know what would be on there, sorry

[@maggielovely1686]

Is this manageable if your a mother with a child? Do you spend a lot of time on the phone, are there set daily hrs or can you start later?

[@LifeAsWendyRN]

What do you mean by your first question? It is a lot on the phone and hours were set for me.

[@user-zw2kl8of6z]

Good Day. What is the average number of review that can be done in a 10 hr shift?

[@LifeAsWendyRN]

hi! We didn't have to meet a number of charts reviewed per day. For us it varied because one case can take hours to solve. I don't have a specific number to provide you with but I know others do have to meet a specific number of charts reviewed.

[@user-zw2kl8of6z]

@@LifeAsWendyRN Thanks for responding to my query. Starting this new journey as a URM and for a few weeks....its different than the usual bedside nurse and its difficult, maybe im still adjusting. Reading progress notes etc and meeting a certain number of review per day. I would agree with you that certain cases would require a lot of time and brain cells. lol.

[@mntn_moth]

I’ve applied to hundreds of UR jobs, professionally updated my resume, and have 5 years in healthcare (2 as an RN Med Surg, critical care and urgent care) and I just keep getting automated rejection emails. 😔😔 I’ve started looking for jobs outside of nursing because of this. Help!!

[@LifeAsWendyRN]

Hi! Are you tailoring your resume to each position you apply? Keep in mind that now a days a lot of our resumes go through softwares first so it’s important to add keywords of the job description to the resume. Good luck!

[@mntn_moth]

Life As Wendy RN yes! I match up my resume with key words from the job description. Still no luck. Hopefully soon 🙏🏼🙏🏼 i’d love to see more day in the life videos for UR ❤️❤️

[@LifeAsWendyRN]

Isabel Villanis I have one coming for this Thursday! I will explain a little bit more of my day. Of course, if I’d include everything we would be here a looooong time lol but it may give you more of an idea of what I do. My position was a little more different to other UR positions from what I’ve heard but nonetheless, it’ll be up tomorrow 😉

[@angeliquegallegos2181]

Hi , what are the steps to becoming UR nurse?

[@LifeAsWendyRN]

I didn’t have any previous experience in UR but did have care coordination experience.

[@edriguepetit]

Thank you for telling me what you do. Yet, I am curious is there a pay increase compared to bedside nursing? Do I need experience to be hired as a utilization review nurse? Please let me know thanks

[@LifeAsWendyRN]

I got a pay increase because I moved within the facility I worked in and was due for a raise. At the time I became a UR nurse I had left bedside 2 years prior and had total of 7 years of nursing experience. I had no experience in UR but did have case management experience

[@dianelbruno9334]

how are you taught the job and for how long?

[@LifeAsWendyRN]

We shadowed a person and then just did it. Training was maybe for like a month or two.

[@SusanaLagmay]

Hi watched your video😊 if i may ask, how much starting salary for UR nurses ?

[@LifeAsWendyRN]

I transferred within a facility I was already at for years prior so that made a difference. Also I live in CA so that’s something to take into account. Starting at the facility i was at can range from 75-85k. And that’s based on many other factors they take into consideration. Hope this helps!

[@chantelevans8534]

How long did you do bedside nursing before this position?

[@LifeAsWendyRN]

Chantel Evans I did bedside for about 4.5 years as a RN. That was my first RN position.

[@chantelevans8534]

Life As Wendy RN after your 4.5 years, was it easy to transition into a UR nurse? Usually there’s certain qualifications you must meet. I’ve been doing bedside nursing for 5 years and I am ready to transition to a non bedside nurse position for better work life balance.

[@LifeAsWendyRN]

Chantel Evans After bedside nursing, I was a primary care clinic nurse for about 3 years. Clinic nurse role included care coordination which is what I think helped me get into my UR RN position. My position is very different to other UR positions from what I have heard from others who have similar titles. This position has a much better work, school, life balance which was one of my main reasons of taking this position. I think it’s just important to apply for the positions that you want and see what happens. Nursing has so many options and bedside is a good foundation but it can take a toll on our lives.

[@chantelevans8534]

Life As Wendy RN Was you clinic nurse position in a hospital setting or office physician setting? Thank you for answering all my questions.

[@LifeAsWendyRN]

Chantel Evans hospital but an outpatient clinic. No problem 😊

[@tinah.208]

Hi! Are you working for an insurance company? How many years of bedside nursing did you have before starting this position? I left bedside due to deteriorating vision but I’d love to get back into nursing in a way that I can still provide safe care

[@LifeAsWendyRN]

Tina H. Hi! No I actually work in a hospital. I was at bedside for 4 years and then clinic 3 years before going into UR.

[@Bettysmiles]

Tina, there's many jobs that dont require bedside nursing but it does involve a lot of paperwork. So I dont know how bad your vision is or if that will affect it. Insurance companies, call nurses like call centers where people call first for recommendations before going to hospital, you follow a script.

[@arelyayala1]

I am a new RN, can I become a UR nurse? or need experience or special certification ?

[@LifeAsWendyRN]

Usually they want acute care experience or previous UR experience or even case management experience. I didn’t have a special certification though. The only thing I had was previous case management experience at a clinic. I did bedside but years before UR.

[@elleelbama]

Yes there are some companies consider new grad like Anthem. I only had few months experience as new nurse and I got an interview. I did not push through with interview though as I accepted a new job before interview.

[@francinesonza3451]

Are UR Nurses there paid higher than Clinical nurses?

[@LifeAsWendyRN]

It really depends. For me, it was a pay increase

[@geea3993]

Do you have a caseload? Or how is the work distributed

[@LifeAsWendyRN]

ga P we do have certain categories of care that we follow and is distributed among the staff

[@geea3993]

Life As Wendy RN idk what that means lol but thanks

[@GodListens77]

How many reviews per hour or day? I'm considering this for and interviewed for it. 3-4 reviews and hour seems high but I don't have a reference. I've been a case manager but not in the UM role. Thanks

[@nikkay3148]

How can I get out of bedside psych nursing?

[@LifeAsWendyRN]

Do you have any case management experience? Just start applying to jobs that you find interesting even if you don’t think you qualify due to lack of experience in that role.

[@nikkay3148]

@@LifeAsWendyRN I don't have any experience except for psych nursing for 4 years

[@LifeAsWendyRN]

@@nikkay3148 4 years of being in a nursing role is an advantage within itself. What area of nursing are you interested in pursuing now? If it’s UR, having case management and care coordination would help. My UR role didn’t need insurance experience but some do. Before I did UR, I did almost 5 years of Med SUrg Tele and then I did primary care for 2 years.

[@nikkay3148]

@@LifeAsWendyRN I will be honest I don't know where I would fit. I didn't have a ton of medical due to working on an acute psych floor. I didn't think of UR. Not sure how to go about getting that. I appreciate you getting back :)

[@LifeAsWendyRN]

@@nikkay3148 no problem! I highly advise you apply to the areas you think you may be interested in. It’s ok if you don’t have experience. You won’t know what you like if You don’t experience it.

[@royjohnson9043]

Do you feel that experience as a review nurse opens doors to future non-beside positions as well?

[@LifeAsWendyRN]

I feel like it did because we did a lot of care coordination so the experience helped with my current role

[@royjohnson9043]

@@LifeAsWendyRN Nice! Whats your role now?

[@HaDealio]

What qualifications did u have to attain or do u have any certificates?

[@LifeAsWendyRN]

HaDealio I don’t have certifications but having case management experience was something that I did have. I do think that having that experience was very helpful.

[@HaDealio]

Life As Wendy RN thanks so much for your reply. What advice would u give to someone who has only done beside nursing for 6 years. Is there a credential that’s needed? I can’t seem to find a job due to not having UR experience. How can I get the experience? Is there a training course? Does CEU’s count?

[@LifeAsWendyRN]

HaDealio I believe there are national certifications available but for that you would probably need 2 year experience to qualify for those certifications. I would advise to just keep applying and possibly find a job that can give u case management experience.

[@willymendoza8411]

🥺

[@x4livin]

The problem, is that after 27 years, there seems to be no way to break out of bedside. No one wants to hire you for UR without extensive UR experience.

[@LifeAsWendyRN]

Have you revamped your resume using key words related to UR? If so, keep applying.

[@kt2666]

I only have 2 years of bedside experience and I got a UM/UR role. I applied to maybe at least 100 UR jobs and only 2 interviewed with me. I got rejected from both at first but then 2 months later one offered me the role. So keep trying!!

[@LifeAsWendyRN]

🔴20% off for membership for WFH job board and crash course to help you land a WFH nursing job: Affiliate link: theremotenurse.com/lifeaswendyrn

[@francinesonza3451]

Currently a Utilization Review Nurse in the Philippines! 🤗🤗

[@omarbanihamdan3144]

Hello, Can you please give more information on how to do utilization nursing job in US while you reside abroad? Thank you

[@corypadiernos8497]

Hi miss francine! Question lng, ano po ba specific work ng ur nurse dito sa atin? Mahirap ba?

[@francinesonza3451]

@@corypadiernos8497 Hello, Maam! We review the case of the patient and determine if patient stay is medically necessary. We’re using Milliman Care Guidelines po 😊 May training din naman po, Maam ☺️

[@francinesonza3451]

@@corypadiernos8497 US-based din yung sa work ko Maam. Yung patients na nirereview namin are patients from US.

[@corypadiernos8497]

Thank you maam! Nag apply din kasi ako kahit no background . Sana matutunan sya agad

[@noonenonya2290]

I've been a nurse for 20+ yrs and have CCM....no one will hire me as a UR nurse..don't get it.

[@LifeAsWendyRN]

carla nonya2 I am sorry to hear that. There could be various variables, could be your resume, your interviewing skills...or maybe at the time, someone else was a better candidate. I am unable to pinpoint why but I can assure you that you will find the right job for you. Just keep applying. Good luck!