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Having a difficult time with understanding the Utilization Management (UM) process/program/initiative of an organization:

1. Identify stakeholders?

2. Who conducts reviews?

3. How are outcomes measured?

4. How are variations reported and to whom?

5. What is the accountability model used (how are clinicians held accountable for variations)?

6. What is the role of physicians/providers?

7. What is the nurses role?

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