- 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 ... requests for services requiring clinical review prior to payment. The Utilization Review Nurse will use appropriate governmental policies as well as… more
- Elevance Health (South Portland, ME)
- …of utilization and/or fraudulent activities by health care providers through prepayment claims review , post payment auditing, and provider record review ... ** Nurse Audit Lead** **Supports the Carelon Payment Integrity... by performing the most complex medical reviews via prepayment claims review and post payment auditing.… more