Inpatient Psychiatric Nurse Lead — Utilization Mgmt

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

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