- 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Martin's Point Health Care (Portland, ME)
- …of clinical nursing experience as an RN, preferably in a hospital setting + Utilization management experience in a health plan UM department Required License(s) ... "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as is responsible...to lower/higher levels of care, makes referrals for care management programs, and performs medical necessity reviews for retrospective… more
- CVS Health (Augusta, ME)
- …clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
- CVS Health (Augusta, ME)
- …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years post… more
- Northern Light Health (Bangor, ME)
- …in a fiscally responsible way. * Works to promote cost containment through utilization management . * Collaborate effectively with physicians and managed care ... Case Management Department * Manages assigned case load, assessing utilization of resources and services; identifying all patient that require additional … more
- Sharecare (Augusta, ME)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
- CVS Health (Augusta, ME)
- …we do it all with heart, each and every day. Drives effective utilization management practices by ensuring appropriate and cost-effective allocation of ... efficient use of healthcare resources. Applies clinical expertise and knowledge of utilization management principles to influence stakeholders and networks of… more
- Northern Light Health (Pittsfield, ME)
- …+ Collaborates with the interdisciplinary team to maximize patient care. Resource Management + Identifies opportunities to improve utilization of resources. ... Work Type: Part Time Eligible Hours Per Week: 20.00 Summary: The Registered Nurse II is a fully competent practitioner of nursing. The incumbent is responsible… more
- Northern Light Health (Brewer, ME)
- …Collaborates with the interdisciplinary team to maximize patient care. + Resource Management - Identifies opportunities to improve utilization of resources. + ... Bangor region has a great position for a registered nurse wanting to make a positive difference in someone's...+ Leadership and Professional Conduct - Utilizes appropriate time management and meets the expectations for punctuality and attendance.… more
- Northern Light Health (Greenville, ME)
- …+ Collaborates with the interdisciplinary team to maximize patient care. Resource Management + Identifies opportunities to improve utilization of resources. ... 6:30 PM to 7:00 AM Eligible for a Sign on Bonus Summary: The Registered Nurse II is a fully competent practitioner of nursing. The incumbent is responsible for the… more