Utilization Review Technician jobs in Maine

Utilization Review Technician conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors patient charts and records to evaluate care concurrent with the patients treatment. Being a Utilization Review Technician reviews treatment plans and status of approvals from insurers. Collects and complies data as required and according to applicable policies and regulations. Additionally, Utilization Review Technician consults with nurses and physicians as needed. Position is non-RN. May require an associate degree or its equivalent. Typically reports to a supervisor. May require Registered Health Information Technician (RHIT). The Utilization Review Technician gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Utilization Review Technician typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)

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UTILIZATION REVIEW CASE MANAGER
  • Covenant Health
  • Lewiston, ME FULL_TIME
  • JOB SUMMARY

    Under the supervision of the VP of Patient Care Services/Chief Nursing Officer and directly reporting to the Director of Care Coordination, the UR Case Manager will work collaboratively with other members of the healthcare team. The case manager also acts as an advocate for the patient and assists in providing information regarding their insurance coverage.

    The UR Nurse Case Manager conducts medical necessity reviews in accordance with the Utilization Management (UM) plan for patients that are housed in a nursing unit, including inpatient admissions, patients receiving observation services, and outpatients in a bed. Identifies delays in care. Documents and communicates findings with the care team and the payor, when necessary.

    JOB REQUIREMENTS

    EDUCATION

    • Associates Degree in nursing required
    • Valid State of Maine RN license required
    • Case Management certification is desirable

    EXPERIENCE

    • Minimum 3 years experience in the following areas: utilization review, discharge planning, and/or social work
    • Knowledge of third-party payer system

    OTHER SKILLS REQUIRED

    • Strong clerical, organizational, and time management skills required
    • Must be able to communicate effectively with patients, families, interdisciplinary team members, and payer
    • Ability to remain objective and impartial

    Covenant Health Mission Statement

    We are a Catholic health ministry, providing healing and care for the whole person, in service to all in our communities.

    Our Core Values:

    • Compassion

    We show respect, caring, and sensitivity towards all, honoring the dignity of each person, especially the poor, vulnerable, and suffering.

    • Integrity

    We promote justice and ethical behavior and responsibly steward our human, financial, and environmental resources.

    • Collaboration

    We work in partnership, dialogue, and shared purpose to create healthy communities.

    • Excellence

    We deliver all services with the highest level of quality while seeking creative innovation.

    Applicants, employees and former employees are protected from employment discrimination based on race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age (40 or older), disability, and genetic information (including family medical history).

  • 23 Days Ago

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Utilization Review Nurse
  • Martin's Point Health Care
  • Portland, ME FULL_TIME
  • Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," ...
  • 6 Days Ago

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Social Worker DCP-Utilization Review
  • Pen Bay Medical Center
  • Rockport, ME FULL_TIME
  • Position Summary Assesses psychosocial needs of patients. Provides individual and family education and counseling. As part of a multidisciplinary team, identifies issues that can pose a barrier to a s...
  • 2 Days Ago

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Social Worker DCP-Utilization Review
  • MaineHealth
  • Rockport, ME FULL_TIME
  • Summary Position Summary Assesses psychosocial needs of patients. Provides individual and family education and counseling. As part of a multidisciplinary team, identifies issues that can pose a barrie...
  • 16 Days Ago

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Care Manager (RN) - Utilization Review
  • MaineHealth
  • Portland, ME FULL_TIME
  • Summary This is a bargaining unit position Date posted: 01/30/2024 For a limited time MaineHealth is offering up to $10,000 Sign on bonus for all eligible experienced Registered Nurses with 1-3 years ...
  • 1 Month Ago

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Registered Nurse (RN) Care Manager - Utilization Review
  • MaineHealth
  • Belfast, ME FULL_TIME
  • Summary For a limited time MaineHealth is offering up to a $10,000 Sign on bonus for all eligible experienced Registered Nurses with 0-3 years of experience and $20,000 for experienced Registered Nurs...
  • 14 Days Ago

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Tech Expert - Friction Clutch
  • Ford
  • Dearborn, MI
  • Job Description We are the movers of the world and the makers of the future. We get up every day, roll up our sleeves an...
  • 3/27/2024 12:00:00 AM

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Display Application Technical Expert
  • Ford
  • Dearborn, MI
  • Job Description We are the movers of the world and the makers of the future. We get up every day, roll up our sleeves an...
  • 3/27/2024 12:00:00 AM

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Switch Team Technical Expert
  • Ford
  • Dearborn, MI
  • Job Description We are the movers of the world and the makers of the future. We get up every day, roll up our sleeves an...
  • 3/27/2024 12:00:00 AM

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ADAS Hardware Components Technical Expert
  • Ford
  • Dearborn, MI
  • Job Description In this position... We are the movers of the world and the makers of the future. We get up every day, ro...
  • 3/27/2024 12:00:00 AM

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Technical Expert
  • Kelly Science, Engineering, Technology & Telecom
  • Hauppauge, NY
  • Quality / Reliability Engineer -- Hauppauge, NY - 6 to 12 Month Contract Assignment No C2C or Sponsorship available at t...
  • 3/25/2024 12:00:00 AM

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Manufacturing Technical Expert (Stamping)
  • American Honda Motor Co Inc
  • Marysville, OH
  • At Honda, The Power of Dreams drives us to create intelligent products that enhance mobility and increase the joy in peo...
  • 3/25/2024 12:00:00 AM

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System Integration Technical Expert
  • Traxen
  • Plymouth, MI
  • We are a Plymouth, Michigan based startup, developing cutting-edge technologies for Driver Assistance and Automated Driv...
  • 3/25/2024 12:00:00 AM

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Billing Technical Expert
  • Grow Therapy
  • New York, NY
  • About us: Grow Therapy is on a mission to serve as the trusted partner for therapists growing their practice, and patien...
  • 3/24/2024 12:00:00 AM

To the south and east is the Atlantic Ocean and to the north and northeast is New Brunswick, a province of Canada. The Canadian province of Quebec is to the northwest. Maine is both the northernmost state in New England and the largest, accounting for almost half of the region's entire land area. Maine is the only state in the continental US to border only one other American state (New Hampshire to the South and West). Maine is the easternmost state in the United States in both its extreme points and its geographic center. The town of Lubec is the easternmost organized settlement in the United...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Review Technician jobs
$60,506 to $84,428

Utilization Review Technician in Little Rock, AR
Based on our compensation data, the estimated salary potential for Utilization Review Technician will increase 16 % over 5 years.
February 07, 2020
Utilization Review Technician in Fairbanks, AK
Current National Pharmacy Technician Certification (PTCB, ExCPT or NCCT) required.
February 03, 2020
Utilization Review Technician in Winston Salem, NC
When considering cost of living, this places Durham, NC as 3rd out of the 4 largest nearby metros in terms of quality of life for Utilization Review Technicians**.
January 02, 2020