Independent CE for utilization management nurses
MedScholaria Consulting, Inc. is an independent, California Board of Registered Nursing (BRN)-approved continuing education provider (CEP #18046) focused only on utilization management (UM) and utilization review: prior authorization, concurrent review, medical necessity, compliance, and the AI tools now entering review. Our courses are for RNs moving into UM and for nurses already doing the work who want CE that reflects it.
Every course awards contact hours (what many nurses call CEUs), accepted in 33 states plus DC. More than 165 nurses have enrolled so far.
We are not affiliated with any health plan, criteria vendor, or staffing company. We teach how utilization management works, not anyone’s product.
Meet the founder: Polina Obshchanska, BSN, RN
Founder, MedScholaria · Lead Prior Authorization Nurse · MSN student in Nurse Administration
I came to the United States from Ukraine in 2015 with intermediate English. I worked as a caregiver, then a hospice aide, then a certified hospital attendant, and studied nursing while raising my children. I earned my ADN in 2020 and my BSN in 2022, became a hospice RN case manager, and then moved into utilization management.
That last move was the hardest. The work was learnable, but almost no one was teaching nurses how to make the transition clearly: the vocabulary, the criteria, the documentation standards, the regulatory timelines.
So I built MedScholaria.
Today I work full time as a lead prior authorization nurse at a California health plan, reviewing complex prior authorization and concurrent review cases for Medicare and Medi-Cal members. I work with medical directors on physician review cases and apply MCG criteria, Medicare coverage policy, and Medi-Cal guidelines every day. I’m also completing my MSN in Nurse Administration, and I’m a mother of three.
Everything I teach at MedScholaria reflects what UM actually looks like in practice — not how it is described in a textbook.
What makes MedScholaria different
Most CE checks the box. MedScholaria builds the foundation.
UM is our only subject
Every course is about utilization management. It’s a large part of nursing that general CE platforms rarely teach in depth.
Written by a working UM nurse
Courses come from daily prior authorization work: real workflows, real documentation standards, and the reasoning behind real determinations.
Current, not recycled
Courses cite current CMS, federal, and state requirements, including the 2026 prior authorization standards and new state laws on AI in utilization review.
Independent
No health plan, criteria vendor, or staffing company shapes what we teach. BRN rules require CE to be free of commercial bias, and we build every course that way.
How We Build and Keep Courses Current
Every MedScholaria course is written by a working prior authorization nurse and built from primary sources: CMS rules and coverage policy, the Federal Register, state laws on utilization review, and current peer-reviewed research. Each course cites its sources, so you can see exactly where a rule or a number comes from.
When the rules change, the courses change. Our 2026 updates added the new CMS prior authorization standards and California’s law on AI in utilization review.
California BRN rules require continuing education to be free of commercial bias. No health plan, criteria vendor, or staffing company pays for, reviews, or shapes what we teach.
Courses last reviewed: October 2026
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.
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.
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…
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.
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.
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.
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.
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.
I liked the short videos, interesting content, and feedback requested. It is very relevant.
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.
Our Utilization Management Courses
Every course is self-paced, case-based, and awards California BRN-approved contact hours.
New to UM? Start with the free UM Career Starter Kit, then take the 1-hour case-based intro to utilization management (1.0 contact hour). It follows one Medicare Advantage patient through prior authorization, concurrent review, and retrospective review.
Preparing for a UM role or already reviewing cases? The 5-hour utilization management course for RNs (5.0 contact hours) covers medical necessity, communication with providers and medical directors, compliance, and professional pathways.
Seeing AI tools show up in your reviews? The AI in utilization management course (3.0 contact hours) explains how AI review tools fit into UM decisions and where nurse judgment still decides the case.
Want all three? The UM Mastery Bundle (9.0 contact hours) includes every course plus the Professional Pathways bonus guides: a UM career map, a resume toolkit, and a directory of where UM nurses get hired.
Not sure which fits? Compare your options. Buying for a team? See group enrollment for nursing teams.
From the Blog
Free guides written from daily utilization review work:
- Utilization management for nurses: what the role really looks like in 2026
- MCG vs. InterQual: what experienced UM nurses need to know
- Inpatient vs. observation status: how UM nurses make the call
- What is AI in utilization management? A nurse’s guide
Credentials
Registered Nurse, California
BSN; MSN in Nurse Administration in progress, Franklin University
California BRN-approved Continuing Education Provider, CEP #18046, Contact hours accepted in 33 states plus DC
Questions about a course, your certificate, or whether UM is right for you? Email polina@medscholaria.com. I answer every message.