Utilization review nurse Interview Questions


Utilization Review Nurse interview questions shared by candidates

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Anthem Blue Cross and Blue Shield
Utilization Review Nurse was asked...July 23, 2020

Tell us about yourself. Describe your work experience. What can you bring to the table for our company.

2 Answers

I am a RN with years of experience with both direct patient care then transitioning into Case Management which has been my focus for over 8 years. I have worked in the role as a Community Based Health Manager with my most recent experience since 2018 - present in Utilization Review, completing reviews using MCG criteria amongst multiple other responsibilities while interacting with team Members and Physicians. Less

I bring to this role a strong work ethic as well as the ability to work efficiently and independently. Less

Passport Health Plan by Molina Healthcare

Why do you think you would be a good fit for this job?

1 Answers

My previous experience was a perfect fit for this jobs requirements and just explained that I was confident in my abilities. Mainly talked about certain cases and how I would handle them in regards to nursing judgement. Less

VA Health

Have you ever had many different tasks given to you at the same time? How did you manage these

1 Answers

Need to say what happened, how you solved the problem and what was the outcome.


why I wanted to change from hands on

1 Answers

I was very Honest I needed a change

McBee Associates

Lets role play an actual phone call to a provider....

1 Answers

Good afternoon ! My name is LauraLynn and I am a nurse calling from McBee Associates on behalf of a patient whom you have had under your care recently. I would like just a few moments of your time to discuss initial eligibility and coverage determinations for “ Mr B “, screening for medical necessity appropriateness, determining additional information required, and referral to correct departments. Is now a good time for you to discuss this in its entire ready or is there a better time either later today or tomorrow for us to discuss this at length? Less

Cambia Health Solutions

How have you handled a time you did not agree with your supervisor?

1 Answers

I requested a private meeting to further my understanding of the issue.

AmeriHealth Caritas

Name a time when..., what is your biggest professional accomplishment up to this point?

1 Answers

When I finished medical assistance program

UnitedHealth Group

If your house was on fire, what would be the top 3 things you would grab from the burning home?

1 Answers

Loaded question. They'll use it to judge you by *their* standards, which may differ from your own. For instance, if you say "pets, husband, purse" they will think that you value superficial stuff over human (not realizing that husbands can get their own self out but pets need help, and if you have your purse/wallet, you can at least call your insurance company and get a room for the night). I bet some interviewers would like to see "my Bible" in that list. Less


What do you do for stress?

1 Answers

Exercise, read a book, listen to music

United States Federal Government

What did you do, as a nurse, that changed the outcome of a patient's care for the better, besides your regular routine care.

1 Answers

I explained that a patient's two grandchildren, aged twelve and thirteen, sought me out to tell me that their grandfather who had a big appetite, loved to eat and was a lot of fun to be with, was not eating, and was being very grumpy with everyone, and "was just not acting like himself", They were very concerned that something was very wrong with him and asked me if I could help him. I discussed with them that their grandfather's surgery along with the post-op care, physical therapy and hospital food might have a lot to do with his mood and appetite, but they both insisted that was not the problem and went on to explain how they had noticed these changes had begun over three weeks prior to his surgery at a family holiday gathering when he started to eat dinner, "made ugly faces", got up from the table and left their home and went back to his own with no explanation ever given. I told them I would look into it for them. At dinner that evening, I stayed with the patient to observe him, and noticed each time he attempted to eat, he he thumped his sternum with his fist. put down his fork. and when I asked if he was OK and he answered yes. After several minutes, he explained in an irritable manner that he was hungry but coud not eat and said it was not the food - he just couldn't, and we began discussing his situation. I contacted his physicianl, and the outcome resulted in the patient ending up in surgery for removal of his gangrenous gall bladder. His grandchildren were absolutely correct about his personality and appetite - he had an ebullient, bouyant personality and ate heartily. After his gall bladder removal, his family members asked me if I was the nurse who saved their father's life, and I told them no, their niece and nephew are his life savers. Less

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