RN Utilization Management Specialist

Hirextra -World's First Staffing Aggregator; Camden (ME); On-site; USD 70,000 - 90,000; Full time

Job summary

A leading healthcare staffing agency is seeking an experienced Registered Nurse (RN) – Utilization Management to support clinical decision-making and ensure appropriate use of healthcare services. This role requires strong assessment skills and experience in utilization review. Responsibilities include conducting utilization reviews, coordinating patient care, and ensuring compliance with regulatory requirements. This is an excellent opportunity for nurses looking for a stable contract assignment.

Qualifications

• Registered Nurse (RN) with current licensure.
• Experience in utilization management or utilization review.
• Strong assessment skills and ability to apply clinical guidelines.

Responsibilities

• Conduct utilization reviews and ensure medical necessity of services.
• Collaborate with providers, payers, and care teams to coordinate patient care.
• Apply evidence-based guidelines to review treatment plans.
• Document and maintain compliance with regulatory requirements.

Skills

Assessment skills

Utilization review experience

Education

Registered Nurse (RN) with current licensure

Job description

A leading healthcare staffing agency is seeking an experienced Registered Nurse (RN) – Utilization Management to support clinical decision-making and ensure appropriate use of healthcare services. This role requires strong assessment skills and experience in utilization review. Responsibilities include conducting utilization reviews, coordinating patient care, and ensuring compliance with regulatory requirements. This is an excellent opportunity for nurses looking for a stable contract assignment.