Course
Introduction to Utilization Management
Contact Hours Awarded: 3
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Course Overview
Author: Joanna Grayson
BSN, RN
Utilization management (UM) is a nursing specialty that has the primary goal of ensuring that patients receive the best medical care possible while managing costs and utilizing available resources to their fullest extent without duplicating services.
LPNs, RNs, and APRNs need to have a basic understanding of the appropriate delivery of quality healthcare services while managing the costs of those services. This course offers an overview of utilization management, the education and certification requirements for the role, and the responsibilities of the utilization management nurse. We will also discuss insurance and legal aspects.
Course Outline
- Introduction
- Utilization Management Process and Steps
- Utilization Management Benefits and Challenges
- Legal Aspects of Utilization Management
- Role of the Utilization Management Nurse
- Pros and Cons of the Utilization Management Nurse Role
- Required Nursing Education and Skills
- A Day in the Life of the Utilization Management Nurse
- The Future of Utilization Management
- Case Study
- Case Study Questions
- Conclusion
- Final Reflection Questions
Accreditation Statement
Nursing CE Central LLC is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.
In this course, we will discuss Introduction to Utilization Management. It will take the average learner 180 minutes to complete and awards 3 contact hours of continuing education.
Course Outcomes
After completing this course, the learner will rate a 4 out of 5 on the Likert Scale for their ability to:
- Describe the purpose and goal of utilization management.
- List the utilization management process steps, benefits, and challenges.
- List the education and certification requirements for the utilization management nurse role.
- Explain the responsibilities and skillset of the utilization management nurse.
Target Audience
- Registered Nurses (RN)
- Advanced Practice Registered Nurses (APRN)
- Licensed Practical Nurses (LPN/LVN)
Requirement for Completion
- Enrollment in the course by the learner
- Read and learn all course materials
- Complete the course evaluation
- Attest and testify learning of the course materials
Accreditations + Approvals
- American Nurses Credentialing Center (ANCC) (P0614)
- California Board of Registered Nursing (CEP 17418)
- Kentucky Board of Nursing (7-0090)
- Louisiana State Board of Nursing (58)
- New York State Department of Education (IC 208)
- New York State Department of Education Child Abuse #80996
- Florida Board of Nursing (50-23983)
Disclosure of Relevant Financial Relationships
Nursing CE Central nor any of the authors, planners, content experts, or any contributors have any relevant financial relationships with ineligible companies to disclose.
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Course Expires on: July 02, 2027
Course Offering: #473