- 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...appropriate courses of action. As a Utilization Management RN working on the OneHome/ Home Solutions… 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CenterWell (Augusta, ME)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- Sharecare (Augusta, ME)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...minimum. + This position will be based in a home office which must satisfy all HIPAA requirements. Sharecare… 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 ... Management Department * Manages assigned case load, assessing utilization of resources and services; identifying all patient that...of care services, to include but not limited to home health services, long-term care, skilled level of care,… more
- Northern Light Health (Brewer, ME)
- …Collaborates with the interdisciplinary team to maximize patient care. + Resource Management - Identifies opportunities to improve utilization of resources. + ... Isle, South Portland, Home Care, Hospice Care, end of life, respite care, Home Health Aide, Skilled Nursing Position Registered Nurse IILocation Req ID 83243 more
- CVS Health (Augusta, ME)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- Wellpath (Windham, ME)
- …memberships and product discounts * Preferred banking partnership and discounted rates for home and auto loans *Eligibility for perks and benefits varies based on ... of care support. **How you make a difference** The Psychiatric Nurse Practitioner(Psych NP)follows established policies and procedures and state guidelines, ensuring… more
- Evolent (Augusta, ME)
- …responsible for support and assistance for all cardiology administrative and clinical utilization management and quality improvement functions under the auspices ... is 11:30-8:00 eastern** **OTHER SKILLS and ABILITIES:** Strong clinical, management , communication, and organizational skills. Demonstrated leadership skills Analytic… more
- CenterWell (Portland, ME)
- …+ Two years as a Registered Nurse with at least one-year of management experience. + Home health experience is preferred. + Management and ... : On-site **Branch Location** : **Portland, ME** **This is not a remote or work-from- home position. This position requires you to sit on-site at our Portland, ME… more