Registered Nurse

Holy Family Medical Center; Lewiston (ME); On-site; USD 50,000 - 68,000; Full time

Benefits offered by this job

Sign-On Bonus Up to $20k (2+ yrs RN)

Sign-On Bonus Up to $10k (New grads)

Job summary

Central Maine Medical Center in Lewiston, ME is seeking a Registered Nurse (RN) for Care Management. The role focuses on care coordination, medical necessity reviews, and collaboration with physicians and payers to drive quality and cost-effective outcomes.

The RN will handle admission reviews, discharge planning, and documentation, working within a multidisciplinary team to optimize patient flow and outcomes.

Qualifications

• Minimum 5 years work experience post-graduation from an accredited school of nursing and a current state RN license.
• RN Case Manager preferred; five years acute care nursing experience preferred.
• Knowledge of Milliman Criteria and InterQual Criteria preferred; basic to intermediate computer skills.

Responsibilities

• Conduct admission and concurrent reviews for medical necessity, severity of illness, and intensity of service.
• Coordinate patient care across the continuum, including discharge planning and transitions of care.
• Collaborate with physicians, payers, and interdisciplinary teams to ensure quality and cost-effective outcomes.
• Advocate for patients while promoting appropriate resource utilization and cost containment.
• Monitor length of stay, barriers to discharge, and care progression.
• Facilitate seamless care delivery across departments and post-acute settings.
• Ensure compliance with regulatory standards (CMS, payer guidelines) and hospital policies.
• Maintain accurate documentation and support utilization review processes.
• Participate in performance improvement and quality initiatives.

Skills

Case management

Discharge planning

Interdisciplinary collaboration

Computer literacy

Education

Registered Nurse license

Tools

Milliman Criteria

InterQual Criteria

Job description

Bonus Amount

Up to $20,000 for Registered Nurses with 2 or more consecutive years of RN experience. Up to $10,000 for New Graduate Registered Nurses

Bonus Information

Sign-On Bonus Available for Qualified Candidates. Eligibility and payout terms apply. Details discussed during the interview process.

Overview

Registered Nurse (RN) – Care Management

Location: Central Maine Medical Center, Lewiston, ME

Full-time | Days | 8 -Hour Shifts

The Registered Nurse (RN) is responsible for care coordination, quality outcomes, and resource management for patients across the continuum of care, beginning at admission through discharge. Ensures medical necessity, appropriate level of care, and cost-effective outcomes through comprehensive review and interdisciplinary collaboration.

Central Maine Healthcare (CMH), a member of Prime Healthcare Foundation, is an integrated healthcare delivery system serving approximately 400,000 residents across central, western, and midcoast Maine through a network of more than 40 primary and specialty care locations. The system includes Central Maine Medical Center (CMMC) in Lewiston, a 250-bed, not-for-profit regional referral hospital that is home to the region's only Cancer Care Center, an orthopedic ambulatory surgery center, and the Central Maine Heart and Vascular Institute. CMMC also serves as the central Maine base for LifeFlight of Maine, the state's only medical helicopter service.

CMH also includes Bridgton Hospital and Rumford Hospital, two 25-bed critical access hospitals that provide essential care to Maine's rural communities.

As part of its commitment to healthcare education and workforce development, CMH is home to the Maine College of Health Professions, Maine's first nursing and medical imaging school. The private, not-for-profit institution is accredited by the New England Commission of Higher Education and plays an important role in training the next generation of healthcare professionals.

To learn more, visitwww.cmhc.org.

Responsibilities

• Conduct admission and concurrent reviews for medical necessity, severity of illness, and intensity of service
• Coordinate patient care across the continuum, including discharge planning and transitions of care
• Collaborate with physicians, payers, and interdisciplinary teams to ensure quality and cost-effective outcomes
• Advocate for patients while promoting appropriate resource utilization and cost containment
• Monitor length of stay, barriers to discharge, and care progression
• Facilitate seamless care delivery across departments and post-acute settings
• Ensure compliance with regulatory standards (CMS, payer guidelines) and hospital policies
• Maintain accurate documentation and support utilization review processes
• Participate in performance improvement and quality initiatives

Qualifications

EDUCATION, EXPERIENCE, TRAINING

1. Starting April 1 2015. Minimum 5 years work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license 2. Grandfathered prior to April 1, 2015. Minimum 5 years post graduate of an accredited school Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred. 3. Five years acute care nursing experience preferred. At least one year experience in case management, discharge planning or nursing management, preferred. 4. Current BCLS certificate, preferred. 5. Knowledge of Milliman Criteria and InterQual Criteria preferred. 6. Experience and knowledge in basic to intermediate computer skills.

Pay Transparency

Central Maine Medical Center offers competitive compensation and a reasonable compensation estimate for this role is $36.00 to $49.16 per hour. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

The company is dedicated to empowering its staff with a comprehensive, competitive benefits package, allowing them the freedom to customize their benefits to fit their unique needs. Our abundant resources, programs, and voluntary options serve as a foundation for individual growth and well-being. Learn more here: https://www.primehealthcare.com/benefitsthatmattermost/

Employment Status

Full Time

Shift

Days

Equal Employment Opportunity

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf