Hospital Nurse III - Utilization Management

maine; Bangor (ME); On-site; USD 53,000 - 67,000; Full time

Job summary

Dorothea Dix Psychiatric Center (DDPC) in Maine is seeking a qualified nursing professional to oversee inpatient utilization management and ensure medical necessity of admissions and stays. You will work under limited supervision, coordinating with medical staff and supporting quality initiatives.

Responsibilities include maintaining UM committees, educating staff, and coordinating with third-party payors. Requires a nursing degree with several years of clinical and leadership experience in a

Qualifications

• Bachelor's degree in nursing or related field plus two years of professional nursing experience; or graduation from accredited nursing school with three years of professional nursing experience.
• Experience overseeing and providing medical/psychiatric nursing care in hospital settings.
• Hospital Utilization Management knowledge is preferred.

Responsibilities

• Revise and ensure adherence to the Utilization Management Plan per CMS and accrediting bodies.
• Provide information to payors or review agencies to justify medical necessity of admissions and stays.
• Collaborate with providers to identify cases not meeting clinical criteria and refer to Clinical Director.
• Maintain Utilization Management Committee membership and communicate data to Medical Staff leadership.
• Provide education regarding Utilization Management and participate in quality initiatives.

Skills

Critical thinking

Communication skills

Attention to detail

Mission alignment

Education

Bachelor's degree in nursing or related field

3+ years professional nursing experience

Job description

Open Date: 10/22/2026

Closing Date: November 5, 2026

Job Class Code: 4135

Grade: 22

Salary: $38.59 - $48.74 per hour*

*Hourly rate is inclusive of a $10.00 per hour salary adjustment stipend and a $.60 per hour institutional stipend

This starting salary is based on education and experience. Starting salary for promotional candidates will follow contractual requirements.

Additional shift differential $3.00/hour while working 2nd shift hours

Additional shift differential $4.50/hour while working 3rd shift hours

Additional weekend differential $2.10/hour while working weekend hours

In addition, candidates may qualify for $200/month nursing student loan reimbursement.

Currently, this position is not eligible for visa sponsorship or STEM OPT extensions.

DESCRIPTION: This is professional nursing work involving the care and treatment of hospital patients who are emotionally, mentally or physically ill. Responsibilities include applying proper nursing principles, practices, and techniques in the care and custody of patients. Supervision may be exercised over a staff of professional and paraprofessional personnel. Work is performed under limited supervision.

REPRESENTATIVE TASKS

• Per CMS and accreditation, licensing and regulating bodies, revises, maintains and ensures adherence to DDPC's Utilization Management Plan.
• Ensures adherence to record review and certification/recertification.
• Proactively manage inpatient utilization to ensure that medical care is appropriate, efficient, and medically necessary.
• Provides adequate information to third party payors, or designated review agencies to confirm the psychiatric medical necessity of the admission and continued hospital stay.
• Collaborates with providers to discuss individual cases and identifies and refers cases that do not meet established clinical criteria to the Clinical Director.
• Responsible for maintenance of Utilization Management Committee membership, committee meetings and conveyance of relevant data and information to the Medical Staff leadership and appropriate individuals, disciplines or additional committees.
• Provides education regarding Utilization Management.
• Will also provide coverage to other disciplines such as Staff Education and Nursing Department.
• Will participate in Quality and Performance Improvement initiatives and reporting in an ongoing basis.

KNOWLEDGES, SKILLS, AND ABILITIES REQUIRED

• You must demonstrate a high level of critical-thinking skills that allows you to process a large amount of information, discern the overall scope of a situation, and make sound decisions based on the information, experience, and knowledge of systems and your scope of practice.
• You must demonstrate good communication skills, exceptional attention to detail, and be able to articulate and employ the Mission, Vision, and Values of DDPC with our staff as well as with community providers.

This bulletin gives an overview of expectations and requirements that do not encompass all duties or expectations of this position. This position may be asked to complete special projects as well as perform work within scope of practice that is not contained herein.

MINIMUM QUALIFICATIONS

• A bachelor's degree in nursing or related field and two (2) years of professional nursing experience -OR- graduation from an accredited school of nursing and three (3) years of professional nursing experience. Experience must include one (1) year overseeing and providing medical and/or psychiatric nursing care in a hospital facility. Preferred knowledge and experience: Hospital Utilization Management.

Agency information

Dorothea Dix Psychiatric Center (DDPC) is a 69-bed psychiatric hospital serving the entire State of Maine that provides services for people with severe mental illness. As a member of a statewide community of care givers, DDPC collaborates with individuals with severe and persistent mental illness, their community and personal supports, to provide recovery-oriented, respectful, compassionate, and effective psychiatric care and treatment in the least restrictive, safest, and most therapeutic environment we can create.

The Department of Health and Human Services (DHHS) is dedicated to promoting health, safety, resilience, and opportunity for Maine people. The Department provides health and social services to appro