Hospital Nurse III - Utilization Management

State-of-Maine; Bangor (ME); On-site; USD 53,000 - 67,000; Full time

Benefits offered by this job

13 paid holidays

12 days sick leave

3+ weeks vacation leave annually

Health insurance coverage

Dental insurance

Job summary

State of Maine’s Dorothea Dix Psychiatric Center is seeking a professional nurse to oversee utilization management and inpatient care, ensuring medical necessity and efficiency. The role includes collaborating with clinical staff, maintaining committee memberships, and contributing to quality improvement initiatives.

The position requires a nursing degree and several years of hospital experience, with leadership responsibilities in Utilization Management.

Qualifications

• Bachelor’s degree in nursing or related field.
• Two years of professional nursing experience, or graduation from an accredited school of nursing with three years of professional nursing experience.
• Experience must include one year overseeing and providing medical or psychiatric nursing care in a hospital facility.

Responsibilities

• Manage inpatient utilization to ensure medical care is appropriate, efficient, and medically necessary.
• Provide information to third party payors to confirm medical necessity of admission and stay.
• Collaborate with providers to discuss cases and refer those not meeting criteria to Clinical Director.
• Maintain Utilization Management Committee membership and related data/reports.
• Provide education regarding Utilization Management and participate in Quality/Performance Improvement initiatives.

Skills

Critical thinking

Communication

Attention to detail

Scope of practice

Education

Bachelor's degree in nursing

3 years of professional nursing experience

Job description

If you are a current State of Maine employee, please submit your application through the internal application process using the Find Jobs report in PRISM. Seasonal employees who do not have PRISM access should apply through the State’s career page and indicate on the application that they have previously worked for the State..Open Date: 10/22/2026Closing Date: November 5, 2026Job Class Code: 4135Grade: 22Salary: $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 stipendThis 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 hoursAdditional shift differential $4.50/hour while working 3rd shift hoursAdditional weekend differential $2.10/hour while working weekend hoursIn 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: (A position may not be assigned all the duties listed, nor do the listed examples include all the duties that may be assigned).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 : (These are required to successfully perform the work assigned).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: (Entry level knowledge, skills, and/or abilities may be acquired through, BUT ARE NOT LIMITED TO the following coursework/training and/or experience). 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 approximately a third of the State's population, including children, families, older Mainers, and individuals with disabilities, mental illness, and substance use disorders. The Department also promotes public health, operates two state psychiatric hospitals, and provides oversight to health care providers.For additional information about this position please contact Jennifer Iverson at 207-561-5425 or email [e-mail] .To apply, please upload a resume and cover letter. To request a paper application, please contact Theresa Peppard at [e-mail] of working for the State of Maine:No matter where you work across Maine state government, you find employees who embody our state motto—\"Dirigo\" or \"I lead\"—as they provide essential services to Mainers every day. We believe in supporting our workforce's health and wellbeing with a valuable total compensation package, including:Work-Life Fit – Rest is essential. Take time for yourself using 13 paid holidays , 12 days of sick leave , and 3+ weeks of vacation leave annually. Vacation leave accrual increases with years of service, and overtime-exempt employees receive personal leave.Health Insurance Coverage – The State of Maine pays 85%-100% of employee-only premiums ($12,213.60 - $14,369.04 annual value), depending on salary. Use this chart to find the premium costs for you and your family, including the percentage of dependent coverage paid by the State.Dental Insurance – The State of Maine pays 100% of employee-only dental premiums ($365.28 annual value).Retirement Plan – The State contributes the equivalent of 14.06% of the employee's pay towards the Maine Public Employees Retirement System (MainePERS).Parental leave is one of the most important benefits for any working parent. All employees who are welcoming a child—including non-birthing parents and adoptive parents—receive six weeks of fully paid parental leave . Additional, unpaid leave may also be available, under the Family and Medical Leave Act .State employees are eligible for an extensive and highly competitive benefits package , covering many aspects of wellness. Learn about additional wellness benefits for State employees from the Office of Employee Health and Wellness .Note: Benefits may vary somewhat according to specific collective bargaining agreements and are prorated for anything less than full-time.There's a job and then there's purposeful, transformative work. Our aim is to create a workplace where you can learn, grow, and continuously refine your skills. Applicants demonstrate job requirements in differing ways, and we appreciate that many skills and backgrounds can make people successful in this role.As an Equal Opportunity employer, Maine State Government embraces a culture of respect and awareness. We are committed to creating a strong sense of belonging for all team members, and our process ensures an inclusive environment to applicants of all backgrounds including diverse race, color, sex, sexual orientation or gender identity, physical or mental disability, religion, age, ancestry, national origin, familial status or genetics.If you’re looking for a great next step, and want to feel good about what you do, we’d love to hear from you. Please note reasonable accommodations are provided to qualified individuals with disabilities upon request.Thinking about applying?Research shows that people from historically excluded communities tend to apply to jobs only when they check every box in the posting. If you’re currently reading this and hesitating to apply for that reason, we encourage you to go for it! Let us know how your lived experience and passion set you apart..If you are unable to complete the online application, please contact the Human Resources representative listed on the job opening you are interested in applying for. They will work with you for an alternative method of submitting..If you are unable to complete the online application, please contact the Human Resources representative listed on the job opening you are interested in applying for. They will work with you for an alternative method of submitting.