What Is an Utilization Management Nurse and How to Become One
Table of Contents
What Does a Utilization Management Nurse Do?
A utilization management nurse ensures that healthcare services are administered appropriately. Their job responsibilities include working in a hospital, health practice, or other clinical setting reviewing patient clinical records, drafting clinical appeals, and overseeing staff members. The qualifications for a utilization management nurse include a nursing degree and a registered nursing license. Most people in this job also have career experience in case management and utilization review.
How to Become a Utilization Management Nurse
In order to become a Utilization Management Nurse, you need to earn a nursing degree and earn your Registered Nurse certification which involves passing the NCLEX exam and getting state licensure. Additionally, you will need to have years of job experience. Many also attain Certified Case Management (CCM) certification. This is a supervisory position, so it’s important to possess qualities of leadership and the ability to manage and collaborate with team members. As a Utilization Management Nurse, you will work in a hospital, health clinic, or similar healthcare setting. You must be detail-oriented, responsive, and dedicated to assuring patients the delivery of the highest quality and most compassionate level of care.
