Maine Licensed Utilization Management Nurse

A company is looking for a Utilization Management Nurse RN - Remote.

Key Responsibilities

Validates authorization for procedures and manages concurrent cases to resolution

Conducts medical necessity reviews and collaborates with care teams to ensure compliance with regulations

Supports denials management and documentation processes according to departmental guidelines

Required Qualifications

Current, unrestricted RN Compact State Licensure or unrestricted RN license in state of residence

3+ years of acute clinical practice or related health care experience

1+ years of Utilization Management RN or Case Management experience