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URAC's accreditation programs include specialty pharmacy, digital health, utilization management, health plan, case management, and others. [4] In order to earn an accreditation, organizations submit various policies and procedures which are reviewed by a nurse or pharmacist and then the Accreditation Committee. [5] Accreditation lasts for ...
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).
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 ...
The American Nurses Credentialing Center (ANCC), a subsidiary of the American Nurses Association (ANA), is a certification body for nursing board certification and the largest certification body for advanced practice registered nurses in the United States, [1] as of 2011 certifying over 75,000 APRNs, including nurse practitioners and clinical nurse specialists.
Certified nurses may earn a salary differential over their uncertified colleagues, but this is rare. Some hospitals and other health-care facilities are willing to pay certified nurses extra when they work within their specialties. Also, some hospitals may require certain nurses, such as nursing supervisors or lead nurses, be certified.
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.
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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.