Job Description
Job Overview
TLC Nursing Associates, Inc. is seeking a skilled and detail-oriented Registered Nurse – Utilization Management (UM) to review healthcare services, ensure clinical appropriateness, and coordinate effective patient care within regulatory guidelines.
Responsibilities
- Review patient medical records, treatment plans, and diagnostic information to assess the necessity and appropriateness of care.
- Collaborate with healthcare providers, insurance companies, and case managers to facilitate approval of services.
- Ensure compliance with clinical guidelines, payer policies, and regulatory standards.
- Analyze utilization data and identify opportunities for care improvement and cost containment.
- Communicate utilization decisions and provide education to providers and patients regarding coverage and care options.
- Document all review activities accurately and maintain patient confidentiality.
- Support quality assurance initiatives related to utilization management processes.
Qualifications
- Current Registered Nurse (RN) license in the state of practice.
- Experience in utilization management, case management, or clinical review preferred.
- Strong clinical assessment, critical thinking, and decision-making skills.
- Knowledge of healthcare regulations, insurance processes, and clinical guidelines.
- Excellent communication, organizational, and interpersonal skills.
- Ability to work independently and as part of a multidisciplinary team.
Benefits
- Competitive pay and flexible contract options.
- Comprehensive medical, dental, and vision insurance plans.
- Opportunities for professional growth and continuing education.
- Supportive work environment with 24/7 access to a dedicated staffing and clinical liaison team.
Job Description
Are you a dedicated Registered Nurse (RN) with expertise in Utilization Management (UM) seeking a rewarding travel healthcare assignment? Look no further than scenic Orono, Maine, where your skills are needed for a 13-week opportunity that promises not only professional growth but also a chance to explore the beauty of the Northeast.
In this role, you will play a crucial part in optimizing healthcare resources by assessing the efficiency and necessity of medical services. Your responsibilities will include reviewing patient records, collaborating with healthcare providers, and ensuring that care aligns with established guidelines and policies. By applying your UM expertise, you will help enhance patient outcomes and streamline healthcare delivery in the Orono region.
This travel nurse position offers a weekly pay of $2172.0, providing you with a competitive compensation package while embarking on a fulfilling adventure in Maine. With guaranteed hours of 40.0 per week, you can focus on delivering high-quality care without worrying about fluctuations in your schedule.
At TLC Nursing, our nurse-founded organization is committed to supporting you every step of the way. From 24/7 recruiter assistance to personalized career guidance, we prioritize your success and well-being. Additionally, we offer valuable benefits such as best-in-the-industry pay packages, a $25,000 life insurance policy effective from day one, and comprehensive medical, dental, and vision insurance options.
Join us in Orono and experience the TLC culture firsthand, where we value your dedication and provide resources to ensure your professional and personal satisfaction. Don't miss this opportunity to make a difference while enjoying the charm of Maine. Apply now and take the next step in your travel healthcare journey.
Job Tags
Weekly pay, Contract work, Flexible hours