Utilization Review or Utilization Management (UM) remains an emerging field in healthcare. Not only do improved practices provide better care and new and improved stewardship or resources, but UM has been proven to reduce hospital readmission rates by 80%.
No one understands this better than Amy Benefield. Amy has been a utilization review manager for over five years, and her leadership spans industry wide.
Today Amy Benefield joins us on the Relode Podcast to discuss her journey from bedside care to utilization review, and some shocking things you might not know about the field. Plus Jen Warneld, an expert recruiter, drops in to talk about things to think about if you're considering looking for a job in UM or hiring a UM nurse.
Listen now and discover a wealth of knowledge, how you might get involved, or keep reading for three key takeaways.
- Understand the industry
Utilization Review covers many different healthcare industries. Acute care utilization review nurses have different experiences than skilled nursing or home health focused practices. If you are interested in utilization, think about how you can merge your existing experiences with the type of review you are most interested in, and research companies that provide that type of managed care.
- Find mentors
There is not one clear path towards a career in utilization review. Every single clinician has a different story of how they made their transition from bedside care to utilization management. Find clinicians who are currently in the role you would like to find yourself in, and ask them how they transitioned. Interested in companies that are employing UM nurses? Check out myNexus' story here.
- Always be learning
The top three qualities a utilization review employer is looking for is someone who is detail oriented, understands managed care regulations, and has the ability to apply those regulations to the care of each patient. Take time to hone your managed care knowledge, and stay up to date with changing regulations.
There is plenty more to unpack from Amy and Jen's wisdom. So, if you want to become a utilization review nurse or learn more about the field, listen to the entire episode. And leave a comment with your best advice for utilization review nurses!