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 skilled Registered Nurse (RN) specializing in Utilization Management (UM) seeking a rewarding travel healthcare assignment in the picturesque town of Orono, Maine? Look no further! This 13-week opportunity offers a competitive weekly pay of $2170.0, providing you with a unique chance to blend work with exploration in a new setting.
In this role, you will leverage your expertise in Utilization Management (UM) to assess healthcare services, ensuring optimal patient outcomes while managing costs effectively. Collaborating with interdisciplinary teams, you will analyze patient data, review treatment plans, and coordinate care to maximize efficiency and quality.
At TLC Nursing, we pride ourselves on our TLC Culture, offering round-the-clock recruiter support, personalized career guidance, and assistance with housing and licensing. As a nurse-founded agency, we understand the importance of providing comprehensive support to our healthcare professionals.
Joining this travel healthcare assignment not only opens doors for professional growth but also grants access to a range of enticing benefits, including Best in the Industry Pay Packages, a $25,000 Life Insurance Policy effective from day one, and Medical, Dental, and Vision Insurance available the 1st of the month after hire. Additionally, you can enjoy Paid Time Off from day one, with eligibility after 1 year of employment, along with a 401(k) plan available after 1 year, fully vested after 5 years.
Don't miss out on this exciting opportunity to immerse yourself in the vibrant healthcare landscape of Orono, Maine. Apply today to take the next step in your travel nursing career.
Job Tags
Weekly pay, Contract work, Flexible hours