- Covenant Health (Lewiston, ME)
- …experience in utilization review , discharge planning, social work case management, or Utilization Manager experience preferred. + Certification ... skills and experience as it relates to the position. Summary The UR Case Manager conducts medical necessity reviews per the Utilization Management (UM) plan… more
- Central Maine Medical Center (Lewiston, ME)
- …of previous experience in Utilization Management and/or Care Management.*BSN preferred.Certified Case manager required within 2 years of hire. If you are ... and for each other every day. Position Summary: The Utilization Management Nurse is responsible for a comprehensive clinical... Management Nurse is responsible for a comprehensive clinical review to assess for medical necessity of outpatient and… more
- Central Maine Medical Center (Lewiston, ME)
- …plans, implements, and evaluates the needs of patients for discharge planning and utilization review . This includes those who may have Medicare, Medicaid, HMO, ... who have an ongoing caring relationship with the patient. Utilization review procedures include those stated for...Documentation meets current standards and policies. + Cooperates with Case Manager 's activities with the insurance company,… more