- Central Maine Medical Center (Lewiston, ME)
- …for our community and for each other every day. Position Summary: The Utilization Management Nurse is responsible for a comprehensive clinical review to ... RN licensure.*Three (3) or more years of previous experience in Utilization Management and/or Care Management.*BSN preferred.Certified Case manager required… more
- CVS Health (Augusta, ME)
- …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...in a hospital setting. + A Registered Nurse that holds an active, unrestricted… more
- CVS Health (Augusta, ME)
- …- Perform medical necessity reviews **Required Qualifications** - 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting - A Registered Nurse that holds an active, unrestricted… more
- Sharecare (Augusta, ME)
- …cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification of those ... to the disease management program intervention guidelines. A Clinical Registered Nurse is supervised by an Operations Manager (OM). All Sharecare clinicians… more
- Central Maine Medical Center (Lewiston, ME)
- …in accordance with hospital policies and procedures. Education and Experience: + Current Registered Nurse licensure in State of Maine. + Is a motivated, ... for each other every day. Central Maine Healthcare is looking for a Clinical Coordinator RN to join their Wound Care team at the Central Maine Heart and Vascular… more
- Humana (Augusta, ME)
- …are currently living in Puerto Rico. + A current, valid and unrestricted license as a Registered Nurse ( RN ) + Minimum of Associate's degree in Nursing + 2 ... community and help us put health first** The **Telephonic Nurse Case Manager ** will be a member...or Master's degree in Nursing + Prior/current experience in Utilization Management/ Utilization Review with MCG + Direct… more
- CenterWell (Augusta, ME)
- …of our caring community and help us put health first** The Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence ... RN license in the state(s) in which the nurse is required to practice + Ability to be...Previous Medicare/Medicaid experience a plus + Previous experience in utilization management, case management, discharge planning and/or home health… more