Utilization Manager RN - Care Management

Central Maine Healthcare is seeking a Utilization Manager RN to join their Care Management team! This is a full time position on the day shift.

The Utilization Management Nurse is responsible for a comprehensive clinical review to assess the medical necessity of outpatient and inpatient services, while maintaining compliance with all regulatory requirements. Work collaboratively with the Physician Advisor and Medicare Director of Care management in determining coverage of requested services; and in collaboration with other disciplines, provide planning and action for quality improvement.

• Meets and maintains the minimum qualifications for the position including:
• Current State of Maine RN licensure.
• Three (3) or more years of previous experience in Utilization Management and/or Care Management.
• BSN preferred
• Certified Case manager required within 2 years of hire.

Full Time

Days

CMH actively promotes diversity in its workforce at all levels of the organization. We strive to create and maintain a setting where we celebrate cultural and other differences and consider them strengths of the organization. CMH is an equal opportunity workforce and no one shall discriminate against any individual with regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, genetic information or veteran status with respect to any offer, or term or condition, of employment.

We make reasonable accommodations to the known physical and mental limitations of qualified individuals with disabilities.

Central Maine Healthcare is an integrated healthcare delivery system serving 400,000 people living in central, western and Midcoast Maine. CMH's hospital facilities include Central Maine Medical Center in Lewiston, Bridgton Hospital and Rumford Hospital. CMH also supports Central Maine Medical Group, a primary and specialty care practice organization. Other system services include the Central Maine Heart and Vascular Institute, a regional trauma program, Life Flight of Maine's southern Maine base, the Central Maine Comprehensive Cancer Center and other high-quality clinical services.

If you are passionate about making a difference and are looking for your next great career opportunity, we look forward to reviewing your application!