A nurse health coach works with patients to help them achieve their health goals. When working with clients, they might: In many ways, this job is similar to case management in that nurse health coaches work individually with people to ensure they have the tools, resources, and information to improve their health and wellness. However, …
A legal nurse consultant (LNC) uses their nursing knowledge and clinical experience to provide expert insight into legal cases involving healthcare issues. An LNC might review medical records to determine whether the standard of care was met in a medical malpractice case or provide context around causation in a personal injury case. The LNC might …
A remote clinical appeals nurse (also known as a denials and appeals nurse) helps patients get the care they need by serving as patient advocates when claims or services are denied by insurance. Nurses in this career review rejected medical claims. Then, they review the medical evidence to understand if the denial was appropriate. If …
A prior authorization nurse reviews requests for medical treatments, services, or procedures to determine whether they qualify for insurance coverage. The job requires nurses to assess, evaluate, and provide recommendations to help ensure patients receive the services they need. Remote prior authorization nursing is a great option for nurses who want to work from home …
The goal of utilization review (UR) or utilization management (UM) is to ensure patients receive quality care without unnecessary services or expenses. While UR and UM are similar, they focus on different points in the care journey. UR/UM nurses can help patients avoid unnecessary medical tests or procedures. They can also advocate for patients by …
