Utilization Review Registered Nurse - 40 hours/week

Job Summary:

MaineGeneral Health is offering an exciting opportunity for an experienced Utilization Review Registered Nurse (RN) to join our team. If you have a passion for service excellence…we want to hear from you!

Job Description:

The Utilization Review Team at MaineGeneral prides itself on being an amazing team that works collaboratively, supporting each other with daily work and decision-making.  In this position, there is the opportunity for flexible scheduling within the core Monday through Friday 40-hour work week.

Responsibilities include:

• Reviews admissions and service requests within assigned unit for prospective, concurrent, and retrospective medical necessity and/or compliance with reimbursement policy criteria.
• Collaborates to assess and coordinate patient's discharge planning needs with members of the healthcare team
• Assists multidisciplinary teams with issues related to medical records/documentation, pre-certifications, reimbursement and claim denials/appeals.
• Monitors for delays in care and prepares data to reduce length of stay and maximize reimbursement.

The Ideal Candidate will have:

• State of Maine licensure as a Registered Nurse (RN) or ability to obtain in a timely fashion, required
• Utilization Review or Care Management experience is strongly preferred.

Scheduled Weekly Hours:

40

Scheduled Work Shift:

Job Exempt:

No

Benefits

Supporting all aspects of our employees’ wellness – physical, emotional and financial – is a critical component of being a great place to work. With the wide range of benefits and programs available, employees have the resources they need to be well at every stage of life and plan for the future.

Physical Wellness:

• We offer quality health, dental, and vision benefits and wellness programs and resources to provide employees access to resources for a healthy lifestyle and help manage health care costs.
• Employees have access to industry-leading leave for new parents.
• A generous earned time plan is offered to all employees - We believe employees need and deserve time away from work to observe holidays, be with family, go on vacation, or simply take care of themselves.

Emotional Wellness:

When life gets challenging, employees have access to our Employee Assistance Program for employees and anyone in their household.

Financial Wellness:

• An employee discount program is available to all employees for services provided by MaineGeneral Medical Center.
• Loan Reimbursement is available for this position dependent upon current degree level.  Please discuss benefit with the recruiter.
• Tuition Reimbursement is available to all employees to further develop skills and career.
• We offer eligible employees up to 2% of eligible pay in 403(b) company-matching contributions plus another 2% in the 401(a) retirement income plan.
• Three insurance plans are available to protect your family from the sudden loss of income in the event of your death, terminal illness or serious injury from accident.
• We offer both short-term and long-term disability insurance to replace a portion of your income if you become disabled and cannot work for a period of time.

Career Mobility:
Helping our employees develop their skills and grow their careers is critical to how we retain our talent and sustain our business. We do this by offering our teammates a variety of leadership-supported programs and learning and development resources for every stage of their professional development. We know that our employees are our most valuable resource they are how we grow our business and care for our community.

Equal Opportunity Employer M/F/Vet/Disability  Assistive technologies are available. Application assistance for those requesting reasonable accommodation to the career site is available by contacting HR at (207) 861-3440 .