Top 4 Cons to Working in Utilization Review

A follow up to my last video, today I am talking about the drawbacks to working in Utilization Review!
If you didn't see the previous video discussing the top 4 pros to working in Utilization Review, you can view it here: • Top 4 Pros to Working ...
Utilization Review is a great option for those who want to use their license without the additional time and money spent on yet another expensive degree or certification!
Time Stamps:
Introduction 00:00
Con #1: Giving bad news 00:53
Con #2: Multitasking 05:14
Con #3: Physical inactivity 06:59
Con #4: Salary lower than some settings 09:15
Ways to Learn More About Utilization Review 13:26
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[@nonclinicalcareerguide]

Get my FREE e-book Nonclinical Resumes That Get Interviews!: sendfox.com/nonclinicalcareerguide I launched the ONLY course on Utilization Review created EXCLUSIVELY by a Physical Therapist working full-time in Utilization Review: nonclinicalcareerguide.thinkific.com/courses/UR

[@cbyt8759]

I am a licensed professional counselor working in the mental health field as a therapist, looking into the utilization review role, so even though I’m sure there are several differences from one field to another, it seems like most of your pros and cons will be largely applicable for me, so I appreciate the time for making these videos and will love to see how else this channel can help me!

[@nonclinicalcareerguide]

Appreciate the comment! Let me know if you have other questions I can answer about Utilization Review?

[@robertcraig1391]

I can understand the need to screen the requested treatment the treating physician has requested. Sometimes the treating physician hasn’t learned about alternative treatment that cost less and is more effective in a particular situation. True some doctors become robotic in their treatment and instead of progressing with scientific procedures will duplicate a process or treatment already tried. What I don’t understand is why so many of the UR decisions mock violations of the AMA Code of Ethics, in particular 8.5, 8.6, 8.9, and 10.2. How and what puts the UR in a position superior to the treating physician? Why aren’t insurance companies returning denials with the UR recommended procedure and why are URs who never see the patient deny something the treating physician has requested?

[@dmurray5588]

The UR job differs everywhere. As a seasoned RN who works for a hospital, that “bad news” is informing the Medical Practitioners(not patients) & either the financial class gets changed vs. a “peer to peer” is requested. Evaluating this actually is good news as you actually are an advocate for the patient. A correct class has been corrected with a financial gain for the hospital-Hopefully no major financial losses for the patient. Also, you are a young gentleman who happens to be a PT. Yes, you would mention inactivity. You will find that age does have a way of catching up with you. I cannot provide direct-care for patients as I did when I was 25 yo. UR is a summary of all of my knowledge of nursing + legal aspects of nursing + my experience of being a former Critical Care Nurse + my Case Management knowledge. Many hospitals have integrated UR with the Case Managers. What area in healthcare do you not multitask? There is no sustainability in HC without appropriate documentation to support it!

[@nonclinicalcareerguide]

I appreciate you taking the time to share your experience! I'm most ignorant about the hospital based UR roles. I agree that each role differs because training new hires has taught me that even within a single company UR jobs different dramatically.

[@rubygilbert4518]

Thank you for this video! I’m new to utilization review with a major insurance company and I didn’t realize how much of my job would be telling people bad news, which I hate. It gives me so anxiety and has me considering another field of nursing.

[@nonclinicalcareerguide]

It isn't fun to give bad news. If you like, I can give you some recommendations that helped me feel more at ease with that aspect. There are many other nonclinical nursing opportunities. If giving bad news makes you anxious, what else do you want to avoid? What would you enjoy doing?

[@rubygilbert4518]

@@nonclinicalcareerguide yes please any advice or tips you have I would greatly appreciate. I don’t think acute care in the hospital is something I want to go back too. I’d like to avoid psych patient populations and aggressive patients. My past traumas left me struggling with anxiety when working with aggressive men alone in their homes when I was doing hospice. I enjoyed working hospice except for the stress of feeling unsafe.

[@parislovelove_heart2346]

Great video!

[@luxuryparkla9244]

Thank you for this information. I have been trying to find the average caseload for a person in UR. How many cases do you review in a day?

[@nonclinicalcareerguide]

Thanks for your question! For me, I complete about 6 cases per day. That includes write ups, phone calls, and final determinations. Work flows vary by company. I know some companies that require >20 cases per day but they also do things differently.

[@peachesroyale]

My company is 15-20 per day