6 years ago, I took a 15% pay cut.

It was the best decision I made.

I'd spent the last several years working in toxic work environments.

Being stepped on, backstabbed, and robbed of my dignity.

I turned down a higher paying job offer.

I went with the one that my gut told me to go for.

For the first time in my life,
I didn't make pay my top priority.

This job actually turned remote during the pandemic.

Had the best coworkers I could have asked for.

Gave me the space I needed to heal.

And yes, eventually came with a raise.

If you're struggling, know this.

Sometimes you need to trust your instincts.

You're much wiser than you think.

Hit “reply” to this email and let me know what you think!

Non-Bedside Job Spotlight

Clinical Appeals Specialist (aka Utilization Review/Appeals )

What do they do?

• Reviews denied claims

• Prepares clinical appeals

• Interprets medical necessity criteria

• Collaborates with providers and insurance reps

• Ensures regulatory compliance

• Advocates for patients

Why Nurses Are a Strong Fit:

• Clinical expertise

• Critical thinking

• Documentation skills

• Interdisciplinary communication

Typical Qualifications:

• Registered Nurse (RN) license

• Clinical experience: especially in acute care, case management, utilization review, or disease-specific specialties.

• Knowledge of medical terminology and coding basics (ICD-10, CPT): often learned on the job or in collaboration with case management.

• Strong writing skills from documentation, care plans, and patient education.

• Understanding of regulations: many nurses are already familiar with Medicare/Medicaid, insurance precertification, and discharge planning requirements.

Additional “nice-to-have” qualifications:

• BSN (sometimes preferred, not always required).

• Experience in case management, utilization review, or prior authorization.

• Certification in Case Management (CCM, ACM-RN) – not always required, but valuable.

Remember, nurses can do jobs that don’t have the word “nurse” in the title!