- Cognizant (Augusta, ME)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Humana (Augusta, ME)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are...+ Minimum of Associate Degree in nursing + Licensed Registered Nurse (RN) in a compact state… more
- Humana (Augusta, ME)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... SRO **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary action… more
- Humana (Augusta, ME)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) Compact license, with no… more
- Humana (Augusta, ME)
- …make an impact** **Required Qualifications** + Associate's Degree or higher + Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary ... health first** This is an opportunity to use your clinical knowledge and research skills to support the coordination,...an 8.5-hour shift between 7:00am - 5:00pm CST. The Utilization Management Nurse 2 uses knowledge, communication,… more
- CenterWell (Augusta, ME)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... an impact** **Required Qualifications** + Must be a licensed Registered Compact Nurse license (RN) with no...Lung or Critical Care Nursing experience required + Prior clinical experience preferably in an acute care, skilled or… more
- Humana (Augusta, ME)
- …help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the coordination, documentation ... Facilities to obtain sufficient clinical information. The Utilization Management Behavioral Health Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) Compact license, with no… more
- Humana (Augusta, ME)
- …**Use your skills to make an impact** **Required Qualifications** + **Active Registered Nurse (RN) Multi-state/Compact State license with no disciplinary ... medication adherence and is trained to act as a clinical concierge. The NAL Telephonic Nurse role...care, skilled or rehabilitation setting, home health, DME, triage, utilization , or case management. + **Ability to work ANY… more
- Sharecare (Augusta, ME)
- …to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they… more
- CenterWell (Portland, ME)
- …+ Graduate of an accredited School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's license, auto insurance ... on-site at our Portland, ME branch location.** The **RN Clinical Manager** coordinates and oversees all direct care patient...and reliable transportation. + Two years as a Registered Nurse with at least one-year of… more
- Datavant (Augusta, ME)
- …clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for...by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well… more
- Highmark Health (Augusta, ME)
- …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
- Northern Light Health (Portland, ME)
- …and strong willingness to relieve the suffering of others. Credentials + Required Registered Nurse Education + Required Bachelor's DegreeIn lieu of education, ... + Ensures a safe work environment, adequate supplies, and appropriate resource utilization for the practice. + Provides a continuous assessment of all practice… more