Hello Ashley, nice to meet you 🙂
I would love to get into Case Management but it seems hard to get into. How did you manage to get into Case Management? Did you take courses to prepare you?
Hi Nicole, nice to meet you too. I actually did not take any courses to enter into Case Management, I was really fortunate that the Director at that time was open to hiring someone without Case Management experience. If you work at a facility with a Case Management Department I would suggest befriending some of the RN Case Managers and ask to see what it is they do. As a nurse you already have the critical thinking skills needed and would need to learn how to use the Utilization Review tool(s) (either Interqual or Milliman),then be able to put everything together. Interqual is probably the most used tool and is ” an evidence-based clinical decision support solution to help payers, providers, and government agencies make clinically appropriate medical utilization decisions.” Learning the tools seem to be the biggest challenge for most people and likely the reason most employers look for Case management experience when making their hiring decisions. If you can find a case manager willing to teach you the basics of Interqual and/or Milliman you have a great chance of getting hired. Unfortunately both tools are licensed products so you will not find much online. Here is a site for Interqual that does give a little information though. Good luck and let me know if I can help you.
Hello Ashley, nice to meet you 🙂
I would love to get into Case Management but it seems hard to get into. How did you manage to get into Case Management? Did you take courses to prepare you?
Nicole
Hi Nicole, nice to meet you too. I actually did not take any courses to enter into Case Management, I was really fortunate that the Director at that time was open to hiring someone without Case Management experience. If you work at a facility with a Case Management Department I would suggest befriending some of the RN Case Managers and ask to see what it is they do. As a nurse you already have the critical thinking skills needed and would need to learn how to use the Utilization Review tool(s) (either Interqual or Milliman),then be able to put everything together. Interqual is probably the most used tool and is ” an evidence-based clinical decision support solution to help payers, providers, and government agencies make clinically appropriate medical utilization decisions.” Learning the tools seem to be the biggest challenge for most people and likely the reason most employers look for Case management experience when making their hiring decisions. If you can find a case manager willing to teach you the basics of Interqual and/or Milliman you have a great chance of getting hired. Unfortunately both tools are licensed products so you will not find much online. Here is a site for Interqual that does give a little information though. Good luck and let me know if I can help you.
https://www.changehealthcare.com/solutions/interqual