Registered nurses (RN) in utilization management (UM) review and optimize aspects of the medical services. This consists of utilization management, as well as assessing customer needs. Along with this process, these registered nurses must be able to implement planned concepts and solutions into real-world practice, and then gather feedback and reports on their performance. Many of the positions do not involve strict supervision, but others do involve active work with positions such as the compliance liaison and case manager nurse.
Registered Nurse (RN), Utilization Management (UM) Tasks
Observe nurses and visit patients to ensure proper nursing care.
Interview or correspond with physicians to correct errors or omissions and to investigate questionable claims.
Consult and coordinate with health care team members to assess, plan, implement and evaluate patient care plans.