- Martin's Point Health Care (Portland, ME)
- …Point has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of the Utilization ... requiring clinical review prior to payment. The Utilization Review Nurse will use...nursing experience as a RN, with a focus of Utilization Management in a managed care environment.… more
- Martin's Point Health Care (Portland, ME)
- …been certified as a "Great Place to Work" since 2015. Position Summary Job Description The Utilization Review Nurse works as a member of a team responsible ... retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use...preferred. + 3+ (total) years clinical nursing experience + Utilization management experience in a managed care… more
- Elevance Health (South Portland, ME)
- **Clinical Operations Medical Director** ** Utilization Management of Medical Oncology Benefits** **Carelon Benefits Management ** **$20,000 Sign On Bonus** ... members and providers. **Job Summary:** + Perform physician-level case review , following initial nurse review ,...maintain knowledge of relevant policies and regulations pertaining to utilization review of oncology care. + Participate… more
- Northern Light Health (South Portland, ME)
- …Collaborates with the interdisciplinary team to maximize patient care. + Resource Management - Identifies opportunities to improve utilization of resources. + ... Schedule: 8:00 AM to 5:00 PM Summary: The Registered Nurse II is a fully competent practitioner of nursing....+ Leadership and Professional Conduct - Utilizes appropriate time management and meets the expectations for punctuality and attendance.… more
- Wellpath (Windham, ME)
- …care through adherence to policies and procedures for admission and transfer, utilization review , and referrals. + Assumes responsibility and accountability for ... of care support. **How you make a difference** The Psychiatric Nurse Practitioner(Psych NP)follows established policies and procedures and state guidelines, ensuring… more
- First Atlantic Health Care (Portland, ME)
- … and analyze facility activities and data to aid planning and cash and risk management and to improve service utilization . + Prepare activity reports to inform ... the first year of employment. + Currently a registered nurse /licensed in Maine. + Certification upon hire or...equipment, and services. + Develop and maintain computerized record management systems to store and process data such as… more
- First Atlantic Health Care (Saco, ME)
- … and analyze facility activities and data to aid planning and cash and risk management and to improve service utilization . + Prepare activity reports to inform ... thinking skill CERTIFICATES and LICENSES + Currently a registered nurse /licensed in Maine. + Certification upon hire or...equipment, and services. + Develop and maintain computerized record management systems to store and process data such as… more
- First Atlantic Health Care (Lewiston, ME)
- … and analyze facility activities and data to aid planning and cash and risk management and to improve service utilization . + Prepare activity reports to inform ... the first year of employment. + Currently a registered nurse /licensed in Maine. + Certification upon hire or...equipment, and services. + Develop and maintain computerized record management systems to store and process data such as… more