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  2. Utilization management - Wikipedia

    en.wikipedia.org/wiki/Utilization_management

    Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...

  3. Nursing management - Wikipedia

    en.wikipedia.org/wiki/Nursing_management

    The chief nurse is a registered nurse who supervises the care of all the patients at a health care facility. The chief nurse is the senior nursing management position in an organization and often holds executive titles like chief nursing officer (CNO), chief nurse executive, or vice-president of nursing. They typically report to the CEO or COO.

  4. Case management (US healthcare system) - Wikipedia

    en.wikipedia.org/wiki/Case_management_(US...

    One of the many certifications that ANCC offers is a Case Management Nurse Certification. Registered nurses who successfully pass ANCC's Case Management Nurse exam [10] are entitled to use the credential, RN-BC (Registered Nurse - Board Certified).

  5. Managed care - Wikipedia

    en.wikipedia.org/wiki/Managed_care

    Utilization management (UM) or utilization review is the use of managed care techniques such as prior authorization that allow payers to manage the cost of health care benefits by assessing its appropriateness before it is provided using evidence-based criteria or guidelines.

  6. Clinical peer review - Wikipedia

    en.wikipedia.org/wiki/Clinical_peer_review

    Likewise, each nurse must participate with other nurses in the decision-making process for evaluating nursing care…Peer review implies that the nursing care delivered by a group of nurses or an individual nurse is evaluated by individuals of the same rank or standing according to established standards of practice….

  7. Registered nurse - Wikipedia

    en.wikipedia.org/wiki/Registered_nurse

    A registered nurse (RN) is a nurse who has graduated or successfully passed a nursing program from a recognized nursing school and met the requirements outlined by a country, state, province or similar government-authorized licensing body to obtain a nursing license.

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