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Utilization Review Nurse Training

Welcome!

Course Welcome
Private Group Codes & Links

Utilization Review Terminology List

Common Terms & Acronyms Printable

Intro to Utilization Review

What is Utilization Review?
Types of Utilization Review
Prospective Review
Prior Authorization Flow Chart
Samples of Coding and Procedural Prior Authorization
Concurrent Review
Retrospective Review

Utilization Review Nursing Process

UR Nursing Process Timeline
1. Service Request
2. Medical Necessity
3. EBP Standard Guidelines
Samples of EBP Conditions Required by Health Plans
4. Practice Setting
5. Determination
Reasons for Denial

Preparing a Case for a Medical Reviewer

Case Preparation

UR Test, Open Note

Quiz

Utilization Review vs Utilization Management

UR vs UM

UR Nurse Career Development

Moving from bedside to UR
Course Assignment
Resume Template
*extra* Resume Bullet Points

UR Nurse Job List

Recommended Companies & Application Tips
FREE Job Board Site Resources
200+ Remote Company Listings

Company Specific Interview Prep

Interview Intro
What to know for a Computer Assessment
Free Microsoft Application Training
CVS/Aetna Interview
Cigna Interview
Centene Interview
Elevance Interview
BCBS Interview
Humana

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UR vs UM

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