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
Ready for an exciting travel healthcare assignment as a Registered Nurse (RN) specializing in Utilization Management (UM) in the serene town of Scarborough, Maine? TLC Nursing is looking for a dedicated RN to join our team for a 13-week opportunity with a competitive weekly pay of $2162.0.
In this role, you will utilize your expertise in UM to assess healthcare service utilization, ensuring efficient and effective patient care. Collaborating with interdisciplinary teams, you will review medical records, develop care plans, and optimize resource allocation to enhance patient outcomes and manage costs effectively.
Joining TLC Nursing means immersing yourself in a supportive environment. As a nurse-founded agency, we offer 24/7 recruiter support, personalized career guidance, and assistance with housing and licensing. We prioritize your well-being and professional growth.
Alongside your clinical responsibilities, you'll enjoy benefits like Best in the Industry Pay Packages, a $25,000 Life Insurance Policy effective from Day One, and comprehensive medical, dental, and vision insurance available the 1st of the month after hire. Additionally, you'll have access to Paid Time Off from Day 1, with eligibility after 1 year of employment, as well as a 401(k) available after 1 year and fully vested after 5 years. Aflac is also available for employee purchase, and our Referral Program offers payouts for bringing in other healthcare professionals. Plus, our Employee Assistance Program (EAP) provides free, confidential services for you and your household through Invest EAP.
If you are a skilled RN with a passion for UM, ready to make a difference in Scarborough, Maine, apply now and take the next step in your travel healthcare journey with TLC Nursing.
Job Tags
Weekly pay, Contract work, Flexible hours