- 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
- Northern Light Health (Waterville, ME)
- …Position is located: Greenville/Jackman Work Type: PRN Work Schedule: Variable Summary: The Registered Nurse II is a fully competent practitioner of nursing. The ... Practice Act, Northern Light Health Standards of Care/Practice, policies and procedures. The Registered Nurse II is responsible for the delivery of patient care… more
- Highmark Health (Augusta, ME)
- …+ Experience in UM/CM/QA/Managed Care **LICENSES or CERTIFICATIONS** **Required** + United States Registered Nurse ( RN ) license + Delaware RN ... Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health care… more
- Highmark Health (Augusta, ME)
- …Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health care ... services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management, and… 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
- Sharecare (Augusta, ME)
- …to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they ... utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification… more