Earn 3 CE Contact Hours! – BRN Approved
Course Overview
Artificial Intelligence (AI) is transforming Utilization Management (UM), medical necessity reviews, and workflow automation. This self-paced, online course provides practical knowledge for nurses, case managers, and healthcare administrators on how AI enhances decision-making while addressing ethical and regulatory considerations.
- Explore AI-driven UM innovations
- Analyze real-world case studies on AI in healthcare
- Understand compliance with CMS, NCQA, and URAC guidelines
Upon completion, participants earn 3 CE contact hours, approved by the California Board of Registered Nursing (BRN).
Course Objectives
By the end of this course, you will be able to:
- Define AI and its applications in healthcare utilization management.
- Describe how AI enhances decision-making in medical necessity reviews.
- Evaluate AI-driven predictive analytics, automation, and cost efficiency.
- Analyze ethical concerns, regulatory requirements, and compliance risks.
- Apply best practices for integrating AI in UM workflows.
Course Format & Learning Experience
- 100% Online & Self-Paced – Learn at your convenience!
- Engaging Content – Case studies, interactive quizzes, and downloadable resources.
- Earn Your CE Certificate – 3 BRN-approved contact hours upon completion.
Who Should Take This Course?
- Utilization Management Nurses
- Case Managers & Healthcare Administrators
- Compliance & Quality Improvement Professionals
- Anyone interested in AI-driven healthcare solutions
What UM Nurses Say
Verbatim feedback from RNs, submitted through MedScholaria course evaluations and testimonial forms. Across 52 course evaluations, 92% agreed the content was relevant to their nursing practice.
Thoroughly enjoyed this class; it provided me with valuable insights into the world of utilization management. I learned a great deal, gaining information that I can apply in this field. The material was presented in a clear and understandable way. I also want to extend my gratitude to Polina, not only for designing the course but also for her guidance and support, which boosted my confidence as I transition into the utilization management arena. I will definitely recommend this class, as it addressed my questions…
This was interesting and encouraging! It lessened my fear that AI will take over my job. I can see there’s an important place for both the medical professional and AI collaborating together for the patients.
This is an excellent introductory course to AI and its role in UM. It is essential in today’s healthcare and tech climate for healthcare providers to keep up with the fast evolving world of UM. This course has been informative and easy to understand. Highly recommend to any practitioners who are currently integrating AI into their work rules.
I liked the short videos, interesting content, and feedback requested. It is very relevant.
This course exceeds my expectations! As a UR nurse transitioning into a leadership role, I found the content practical, organized, and applicable to daily work. Whether you’re new to utilization management or looking to strengthen your utilization management knowledge, this course is perfect. You can tell a lot of thought and expertise were utilized throughout the course. I highly recommend it to anyone interested in learning about utilization management. It is an excellent investment in your professional growth.
Ive been trying to get a job in Utilization Review as an RN, but unfortunately, I don’t have the needed experience, so I found this course to learn all about the job. It has really helped me understand the role.
I found this course to be an informative look at a position in nursing that allows the use of all former bedside skills and clinical knowledge. Introductory information was abundant in UM, and the comparisons and differentiations between Case Management and Utilization Management were extremely well presented. Real-world examples helped to increase my understanding of the information. I would encourage nurses to take this interesting CEU class.
I’m new to UM, and this course broke everything down in a way that was easy to follow. It’s a great starting point for beginners.
One stop shop for all basics required to understand the role in detail, and the use of tools and workflows related to potential job opportunities.
Course information presented clearly and concisely. Self-paced format allows for great flexibility. If one is curious about the role of a nursing professional in the Utilization Management, I recommend this course as a great starting point.
UM is more sophisticated than most staff think!
I appreciate the simplicity of this course and look forward to taking more courses immediately.
Thank you for this informative and affordable course! I learned a lot!
Good for novice who wants to know more about UM.
Very informative and presented in a clear manner.
Course Pricing & Enrollment
- Standard Price: $99
- Questions? Contact Us: polina@medscholaria.com
Instructor Bio
Polina Obshchanska, BSN, RN – Lead Utilization Management Nurse, Continuing Education Provider, and MSN student in Nurse Administration. Polina has almost 10 years of experience in healthcare, including hospice, case management, utilization management and healthcare quality, and is the founder of Medscholaria Consulting, Inc., a BRN-approved CE provider focused on empowering nurses through relevant, timely, and nationally impactful education.
Refund & Cancellation Policy
Course purchases are non-refundable once course access has been granted. If a technical issue prevents course access, contact polina@medscholaria.com within 7 days of purchase and we will resolve it or issue a refund at our discretion. Should MedScholaria Consulting, Inc. cancel the course, a full refund will be provided within 10 business days.
BRN Provider Statement
“Provider approved by the California Board of Registered Nursing, Provider Number CEP18046, for 3 contact hours.”
