Top 18 Utilization review nurse Jobs in Portland, Me

Care Manager RN - Per Diem
Optum —Portland, ME
- $28.27 - $50.48 an hour
- Full-time
- Nursing
- RN License
- Hospital
- Flexible schedule
Licensed Practical Nurse
TalentBurst, Inc. —Westbrook, ME
- $1,120 - $1,156 a week
- Contract
- CPR Certification
- Nursing
- Computer literacy
- Health insurance
- Dental insurance
Quick Apply
2d
Travel RN - Case Management/Utilization Review - Case Management
American Traveler —Portland, ME
- $2,304.56 a week
- Contract
- RN License
- Hospital
- Mid-level
Quick Apply
4d
NURSE- Part Time Night RN
GUARDIAN RECOVERY NETWORK HOLDINGS LLC —Portland, ME
- $40 - $48 an hour
- Part-time
- CPR Certification
- Nursing
- Psychiatry
Quick Apply
NURSE- Part Time Day RN
GUARDIAN RECOVERY NETWORK HOLDINGS LLC —Portland, ME
- $36 - $42 an hour
- Part-time
- CPR Certification
- Nursing
- Psychiatry
Quick Apply
NURSE- Full Time Night RN
GUARDIAN RECOVERY NETWORK HOLDINGS LLC —Portland, ME
- $40 - $48 an hour
- Full-time
- CPR Certification
- Nursing
- Psychiatry
Quick Apply
NURSE- Full Time Day RN
GUARDIAN RECOVERY NETWORK HOLDINGS LLC —Portland, ME
- $36 - $42 an hour
- Full-time
- CPR Certification
- Nursing
- Psychiatry
Quick Apply
NURSE- Part Time Evening LPN
GUARDIAN RECOVERY NETWORK HOLDINGS LLC —Portland, ME
- $32 - $38 an hour
- Part-time
- CPR Certification
- Nursing
- Psychiatry
Quick Apply
Mental Health Nurse Practitioner
CFG HEALTH SYSTEM LLC —Portland, ME
- Per diem
- Nursing
- Doctoral degree
- BLS Certification
Quick Apply
Registered Nurse | Review Analyst I | Remote | Detroit, MI | Contract
Walker Healthforce, LLC —United States
- Contract
- Remote
- Nursing
- RN License
- 3 years
- Health insurance
- Dental insurance
Quick Apply
3d

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Case Manager / PRN ( RN / RT / SW / LPN )
Select Specialty Hospital - Columbus Vic Village(Grant) —Columbus, OH
Current licensure in a clinical discipline either as a Nurse (RN /LPN/ LVN)or a Respiratory Therapist OR current license / certified Social Work license per…
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Utilization Review Specialist - Autism
Nationwide Children's Hospital —Columbus, OH
Bachelor’s Degree in Social Work, Psychology, or related field, required. Documents all case reviews and maintains accurate records of all clinical activities…

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Care Manager RN - Per Diem

Optum -
Portland, ME

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Job Details

Full-time
$28.27 - $50.48 an hour

Benefits

Flexible schedule

Qualifications

RN License
Windows
Task prioritization
Desktop applications
Typing

Full Job Description

Opportunities at Northern Light Health, in strategic partnership with Optum. Whether you are looking for a role in a clinical setting or supporting those who provide care, we have opportunities for you to make a difference in the lives of those we serve. As a statewide health care system in Maine, we work to personalize and streamline health care for our communities. If the place for you is at a large medical center, a rural community practice or home care, you will find it here. Join our compassionate culture, enjoy meaningful benefits and discover the meaning behind: Caring. Connecting. Growing together.

The Care Manager RN - Per Diem provides leadership in the coordination of patient-centered care across the continuum, develops a safe discharge plan through collaboration with the patients/caregivers and multidisciplinary healthcare team to arrange appropriate post discharge services and optimal transitions in care. Facilitates appropriate LOS, patient experience, and reimbursement for all patients. Develops and maintains collaborative relationships with all members of the healthcare team. Through clinical care coordination drives efficient utilization of resources to reduce length of stay, improve patient flow and throughput, limits variation by applying innovative and evidence-based practice, and to reduce the risk of readmission.

Schedule: Flexible Schedule - Required to work 1 Saturday Quarterly

Location: 175 Foreriver Parkway, Portland, ME

Primary Responsibilities:

Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory requirements, etc.; serves as an educational resource to all Health System staff regarding utilization review
Assumes roles in assessment physical, psychosocial, & economic needs for transition of care planning to a variety of levels of care, delegates to others as appropriate
Documents, verifies, and validates specific data required to monitor and evaluate interventions and outcomes
Interviews and collects patient specified data and chart review related to readmission and appropriately notifies care team
Communicates telephonically and electronically with outpatient providers to enhance the continuum of care
Integrates performance improvement principles and customer service excellence principles into all aspects of job responsibilities, practice and governmental commercial payer guidelines
Adheres to the policies, procedures, rules, regulations, and laws of the hospital and all federal and state regulatory bodies
Assume responsibility for Health System required continued education and owns professional growth
Performs tasks of a clinical nature within scope of assigned duties and clinical expertise
Communicate effectively in both oral and written form, as appropriate for the needs of the audience
Performs other duties as assigned or required

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

Associate's Degree (or higher) in Nursing
Current, unrestricted RN license in the state of employment
1+ years of experience in a hospital, acute care, or direct care setting
Intermediate level of proficiency to navigate Windows based environment and the ability to type
Ability to work one Saturday, quarterly

Preferred Qualifications:

Bachelor's Degree in Nursing (BSN)
Previous background in managed care
Certified Case Manager (CCM)
1+ years of Case management experience
Experience or exposure to discharge planning

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

#RPO #RED #RPOLinkedin

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utilization review nurse jobs in portland, me

Care Manager RN - Per Diem

Licensed Practical Nurse

Travel RN - Case Management/Utilization Review - Case Management

NURSE- Part Time Night RN

NURSE- Part Time Day RN

NURSE- Full Time Night RN

NURSE- Full Time Day RN

NURSE- Part Time Evening LPN

Mental Health Nurse Practitioner

Registered Nurse | Review Analyst I | Remote | Detroit, MI | Contract

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