Courses teach you UM. This utilization review training for nurses has you do it: three Medicare Advantage reviews you complete yourself, written notes graded by a Lead Prior Authorization Nurse, and a Career Kit that turns that practice into interview answers.
Join the waitlist See what’s included
The question every UM interview asks
“Walk me through how you would review this request.” Hiring managers want to hear how you chose the criteria, what you asked the provider for, and when you would send a case to the physician reviewer. Most nurses applying for their first UM role have never done a review, so they answer in general terms.
The Job-Ready Program is utilization review training for nurses built around practice: three complete reviews to talk about, with feedback from someone who does this work every day.
What’s included
UM Mastery Bundle
All three MedScholaria courses, from UM foundations through medical necessity, documentation, communication, compliance, and AI in UM.
- Your UM Career Map
- The UM Resume Toolkit
- Where UM Nurses Get Hired
Utilization Review Case Lab
Three reviews of one fictional Medicare Advantage member: outpatient prior authorization, day-by-day inpatient concurrent review, and post-acute review. You build the timeline, choose the criteria, and write the notes.
Personal feedback on your notes
Your written notes are graded by the instructor against a published rubric within 5 business days, with written feedback and one resubmission per case.
Case Lab Career Kit
Guides for using the Case Lab in your job search.
- Interview prep guide
- How to talk about your Case Lab reviews in interviews
- LinkedIn guide and worksheet
- Exact wording to list it on your resume
Three utilization review training cases
You follow Mrs. Tilly Teacup, a fictional 74-year-old Medicare Advantage member, through three episodes of care. Every case uses public Medicare rules only.
- Outpatient prior authorizationHer oncologist requests an FDG PET/CT for newly diagnosed breast cancer. You decide whether National Coverage Determination 220.6.17 covers the purpose of the scan.
- Inpatient concurrent reviewShe is admitted with an acute ischemic stroke, and the request lists the wrong diagnosis. You review her stay one hospital day at a time.
- Post-acute reviewThe hospital requests inpatient rehab she cannot yet tolerate. You route that request correctly, then review the skilled nursing facility request that follows.
No MCG or InterQual content is used or provided. All patients, providers, and facilities are fictional.
What you can say in your next interview
“I reviewed an outpatient PET/CT request against a national coverage determination and wrote the outreach for missing information.”
“I did day-by-day concurrent review of a stroke admission and advanced days only when the milestones were documented.”
“I routed an inpatient rehab request, reviewed the SNF request, and wrote a physician referral that asked one clear clinical question.”
How this utilization review training for nurses works
- Join the waitlistWaitlist members get 48-hour early access on Wednesday, November 25, before doors open on Black Friday.
- Complete the bundle coursesThey’re included. If you already finished them, you go straight to the Case Lab.
- Work the casesCases open one at a time. Decision quizzes score instantly; your notes come back graded within 5 business days.
- Earn your certificateDownload your Case Lab certificate after all three cases pass, then use the Career Kit to put it to work.
Pricing
To keep grading on time, the program takes 7 new learners a month.
| Founding price (first 5 seats) | Regular price | |
|---|---|---|
| UM Job-Ready ProgramBundle + Case Lab + Career Kit, 21.0 CE hours | $797 | $997 |
| Already own the UM Mastery Bundle?Your full $277 is credited | $520 | $720 |
The founding price ends when all 5 seats are taken or on December 31, 2026, whichever comes first.
Join the waitlistWho grades your notes
Polina Obshchanska, BSN, RN, is a Lead Prior Authorization Nurse on a Medicare and Medi-Cal prior authorization team, where she reviews cases and coaches new reviewers. She is the founder of MedScholaria Consulting, Inc. and grades every Case Lab note personally.
What nurses say about MedScholaria courses
“This course exceeds my expectations!”
Maggie Munoz, RN, Inpatient UM Supervisor, 6.5 years of UM experience across payer-side and hospital UM“After completing this course and following Polina’s recommendations on improving my resume and using the right wording, I reapplied for jobs. The next day, I immediately received two interview invitations!”
Kyra Martinez, BSN, RN, UM Mastery Bundle graduate · Read her storyFrequently asked questions
Do I need UM experience?
No. This utilization review training for nurses needs only an active RN license. The bundle courses take you from foundations to review-ready before the Case Lab opens.
I already own the UM Mastery Bundle. What do I pay?
Your full $277 is credited: $520 at the founding price, $720 after. If you have finished the bundle courses, the Case Lab opens right away.
Will this get me a UM job?
No course can guarantee a job. What you get is three complete reviews you can describe in detail, graded feedback from a working reviewer, and guides for your resume, LinkedIn, and interviews.
Does the Case Lab use MCG or InterQual?
No. The cases use only public criteria: national and local coverage determinations, the Medicare Benefit Policy Manual, federal regulations, and teaching criteria built from published evidence.
How long does it take?
The Case Lab is about 12 hours of work, on top of the bundle courses. It’s self-paced: cases open one at a time and your notes come back graded within 5 business days, so plan on a few weeks from your first case to your certificate.
I’m an LVN or LPN. Can I join?
Yes. CE credit is issued for RNs; LVN and LPN learners receive a certificate of completion while acceptance is confirmed with their board.
Why only 7 learners a month?
Every note is graded personally. Capping enrollment keeps feedback within 5 business days.
What is the refund policy?
Program purchases are non-refundable once course access has been granted. If a technical issue prevents access, contact polina@medscholaria.com within 7 days of purchase and we will resolve it or issue a refund at our discretion.