Day in the life: Utilization Manager/ Clinical Reviewer I have another one for you guys! I found these super helpful when trying to decide what role I wanted to move towards next in my career. I was in a 100% remote, Utilization Management role paying around 82k (Hello salary transparency 👏🏼) 8:00: log on from home - Check emails - Set up phone queue 8:15: jump into patient queue - work oldest to newest auths 10: meeting of some sort - rounds with Medical Director or - internal meeting on process we are inproving or - 1:1 with my boss 11: back to the queue - try to hit my number for the day - take random calls on cases that aren’t mine and I know nothing about :) 2:00: lunch break (had to take an hour) 3:00: work on an internal project/ run some reports and finish auths for the day 5:00: slam laptop shut For all my UM/ Clinical Reviewer friends what am I missing!?
Lauren, thank you for sharing your “day in the life”. It is really helpful info for those of us seeking to transition to non-clinical roles! I applaud and appreciate your boldness in regard to pay transparency.
That's an overall good summary! Since the drop in pay was something I factored in about going nonclinical: I would add that many companies offer an annual bonus. I thought about writing blogs about my day when I started as a Pre-Service Coordinator in 2021. Someone told me "that sounds boring" so I chose not to go that route. 🤣
Love this insight as so many times this role is touted as the ideal alternative career!
By far the least enjoyable aspect of that job was the phone queue. Taking calls from irate MDs who missed a peer review deadline was not fun and it seemed some reviewers were frequently "unavailable" for calls regarding their own cases. Congrats on finding a more fulfilling role Lauren!
Thanks Lauren! for sharing this insightful glimpse into a day in the life of a Utilization Manager/Clinical Reviewer! Your transparency sheds light on the diverse and impactful work you do. Wishing you a continued success in your career journey! 👏🌟
Love this post!! Thank you for the transparency. Would love to pursue an opportunity in this area of healthcare one day hopefully.
Thanks for posting Lauren! Was this role fulfilling? Is this current role? or a past role? The schedule seems appealing and like you are NOT bored and making an impact.
In a slightly different role within UR. The role I’m in is much more case management oriented. My role is also hybrid so it breaks up the week and I get to see providers and members in the flesh. Day-to-day is different for me depending on if I go on site. Regardless, lots of patient, family and provider outreach to facilitate a safe discharge. In terms of pay, I think this will vary based on years of experience, type of UR role, company and location! However, the range based on my experience and conversations with others is roughly 80-90k to start, with opportunity for annual raise, bonus etc 😀
What the job information please
Utilization Management Professional | Healthcare Operations Specialist | Client Success Focused
9moYou were in a different division than I am, so there are some minor differences with my role. Some UM roles do more case management and discharge planning (my division does not). We do reach out to providers if we have clinical questions or need additional clinical sent over. We also call the ordering physicians office to offer an opportunity for a peer to peer with our medical director on cases that do not appear to be meeting criteria (I'm not sure this is standard across companies though.)