The Role of Artificial Intelligence in Utilization Management – Enhancing Healthcare Decision-Making

$69.00

Trusted by RNs

Real feedback from nurses who completed The Role of AI in Utilization Management

5 reviews

Most recent: Oct 2025

“With this course help me understand the use AI in utilization management and can use the knowledge in the future.” — Rizalino Baesa, RN

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“With this course help me understand the use AI in utilization management and can use the knowledge in the future.” — Rizalino Baesa, RNOct 2025

“Thank you” — Evelyn Akinnodi, RNJul 2025

“Very interesting and fresh topic, thank you” — Tetiana, RNMay 2025

“Informative content” — Antonina Kalinina, RNMay 2025

“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.” — Natalia Guchko, RNMay 2025

Category:

📢 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

Course Pricing & Enrollment

  • Standard Price: $69
  • 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

If a participant cancels their enrollment within 48 hours of purchase, they are eligible for a full refund. No refunds will be issued for incomplete or partially completed courses. If MedScholaria Consulting INC cancels the course, a full refund will be processed within 10 business days.

BRN Provider Statement

“Provider approved by the California Board of Registered Nursing, Provider Number CEP18046, for 3 contact hours.”

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