10 Things I like about the Utilization Management Job

I have been a hospitalist for more than a decade a few years ago. At that point, I thought I should do something different. Luckily, my medical director supported me to join UM committee and start doing status reviews. I really liked the work. For the first time, I could read notes written by physicians from different specialties and learn a lot in the process.

Apart from the things I do not like about UM job, there are certain things I really like about Utilization Management job. Here I will list some of the things I really like about Utilization Management job.

  1. Remote work: I get to work from home for my UM job. It was really helpful during the pandemic time. It was very scary when I heard news of physicians losing life while taking care of patients. There was a time I even thought that I should quit my job and look for something else as I was still doing part time clinical work.
  2. Critical thinking: The search for clinical indicators in the whole chart and putting together all those indicators to arrive at a decision to support Inpatient status needs critical thinking which I love. Sometimes, it can be hard especially when length of stay is long, and documentation is poor.
  3. Healthcare Efficiency and Reduction of costs: It helps me to directly impact patient care by ensuring appropriate utilization of resources. This in turn helps improve revenue for the hospital I work for.
  4. Continuous Learning: I learn continuously as I read the charts and the treatments the patients get. Sometimes, I make a note of certain treatments or guidelines that I learn while reading charts. I get to read pediatric patients charts and OBGYN notes which I otherwise do not treat that much. I learn a lot in the process.
  5. Advocacy: This job helps me to advocate for patients while balancing cost-effectiveness. If the patient meets IP status, I feel that I am fighting for the patients by doing P2Ps and saving money for them when I overturn the denials.
  6. Career Growth: UM experience can lead to other roles in healthcare administration. I have seen physician advisors becoming healthcare leaders like Chief Medical Officer [CMO]. May be one day, I may choose to become a healthcare leader for some other organization.
  7. Spending time with kids: This career definitely helps to spend an hour extra a day with kids on an average. I could not do that with 12hr shifts as a hospitalist.
  8. Flexibility in job: My hospitalist job was 7ON 7OFF model. I used to work for 7 days in a row with 12hr shifts and it was stressful. Now, with UM job, even though the shifts are 12hrs each, I do not work 7 days in a row. I work anywhere from 1 day to 7 days in a row. Overall, it gave me more flexibility than my hospitalist job.
  9. Easy Transition: As I have been working in the same hospital for 14 years, I know how the process works very well in my hospital. Its very easy for me to reach other physicians and discuss or explain why we recommend change of status.
  10. Continue Clinical duties: Even though majority of my work is in UM job, I still am able to work in the hospital setting taking care of patients.