Senior Psychiatric Nurse - Utilization & Care Leader

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

Benefits offered by this job

Nursing student loan reimbursement

Shift differentials

Job summary

Dorothea Dix Psychiatric Center (DDPC) in Maine seeks a professional nurse to oversee hospital-based utilization management, ensuring medically necessary care and efficient resource use. You will collaborate with clinicians, review admissions, and contribute to quality and performance improvement initiatives.

The role requires a nursing degree and several years of experience in hospital settings, including leadership responsibilities.

Qualifications

• 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.

Responsibilities

• Revises, maintains and ensures adherence to Utilization Management Plan as per CMS and accrediting bodies.
• Ensures adherence to record review and certification/recertification.
• Proactively manage inpatient utilization to ensure medical care is appropriate, efficient, and medically necessary.
• Provide information to third party payors or review agencies to confirm psychiatric medical necessity of admission and continued stay.
• Collaborate with providers to discuss cases and refer those not meeting clinical criteria to Clinical Director.
• Maintain Utilization Management Committee membership, meetings, and convey relevant data to Medical Staff leadership.
• Provide education regarding Utilization Management.

Skills

Critical thinking

Communication skills

Attention to detail

Mission alignment

Education

Bachelor’s degree in nursing or related field

Job description

Dorothea Dix Psychiatric Center (DDPC) in Maine seeks a professional nurse to oversee hospital-based utilization management, ensuring medically necessary care and efficient resource use. You will collaborate with clinicians, review admissions, and contribute to quality and performance improvement initiatives.

The role requires a nursing degree and several years of experience in hospital settings, including leadership responsibilities.