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Utilization Review Registered Nurse (RN) at MaineGeneral Health - ApplyBlast

Utilization Review Registered Nurse (RN)

MaineGeneral Health

1 month ago

3.7 on Glassdoor

Augusta, Maine, United States

Onsite

Full Time

Medior

0 applicants

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About this role

MaineGeneral Health is seeking an experienced Utilization Review Registered Nurse to join their collaborative team, focusing on patient care coordination, utilization management, and reimbursement. The role involves reviewing medical necessity, coordinating discharge planning, and working with multidisciplinary teams to optimize patient care and maximize reimbursement. This position offers an opportunity to apply clinical expertise in a supportive environment dedicated to professional growth and community impact.

Responsibilities

Review admissions and service requests for medical necessity and reimbursement compliance
Assist multidisciplinary teams with documentation, pre-certifications, and claim appeals
Coordinate patient discharge planning and monitor care delays to reduce length of stay