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Insurance Utilization Review Jobs in Maine (NOW HIRING)

American Traveler

Travel Care Manager

Portland, ME · On-site

Coordinate patient care management and utilization review activities * RTO should be kept to a ... life insurance beginning day one of your assignment, generous 401(k) match, substantial housing ...

Dane Street, LLC

Board-Certified Neurologist

Portland, ME · On-site

$327K - $409K/yr

... peer review services, trusted by insurance carriers and organizations across the country for ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...

Dane Street, LLC

Board-Certified Neurologist

Portland, ME · On-site

$327K - $409K/yr

... peer review services, trusted by insurance carriers and organizations across the country for ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...

Dane Street, LLC

Board-Certified Neurologist

Portland, ME · On-site

$327K - $409K/yr

... peer review services, trusted by insurance carriers and organizations across the country for ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...

Dane Street

Board-Certified Neurologist

Portland, ME · On-site

$332K - $415K/yr

... peer review services, trusted by insurance carriers and organizations across the country for ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...

UnitiMed

RN Case Manager

Biddeford, ME · On-site

Day 1 Insurance * * Cigna medical, MetLife dental and vision insurance * * License reimbursement ... Referral bonus up to $700 Registered Nurse (RN),Case Management/Utilization Review, About the ...

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All JobsInsurance Utilization Review JobsInsurance Utilization Review Jobs in Maine

Insurance Utilization Review information

See Maine salary details

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$40

$66

How much do insurance utilization review jobs pay per hour?

As of Aug 15, 2026, the average hourly pay for insurance utilization review in Maine is $40.94, according to ZipRecruiter salary data. Most workers in this role earn between $32.36 and $47.02 per hour, depending on experience, location, and employer.

What are the most common challenges faced by insurance utilization review professionals?

One common challenge in Insurance Utilization Review is balancing the need for cost-effective care with the clinical needs of patients, which often requires careful analysis and decision-making. Professionals in this role frequently navigate complex medical records, strict policy guidelines, and collaborate with healthcare providers who may advocate strongly for particular treatments. Managing challenging conversations while maintaining professionalism and ensuring timely determinations are also a regular part of the role. Developing expertise in these areas can make the job both demanding and rewarding, while building a strong foundation for career growth within healthcare administration.

What are the key skills and qualifications needed to thrive in insurance utilization review?

To thrive in Insurance Utilization Review, you generally need a strong background in healthcare or nursing, an understanding of medical terminology, and analytical thinking skills, often supported by an RN license or relevant clinical experience. Familiarity with utilization management software, coding systems like ICD-10, and knowledge of regulatory requirements (such as Medicare or Medicaid) are important. Strong communication, attention to detail, and problem-solving abilities help professionals excel when interacting with providers and insurers. These skills are essential to ensure appropriate care is authorized while maintaining regulatory compliance and cost-effectiveness.

What is an insurance utilization review?

An Insurance Utilization Review job involves evaluating medical treatments and services to determine if they are necessary, appropriate, and covered by a patient's insurance plan. Professionals in this role review medical records, treatment plans, and insurance policies to ensure compliance with guidelines and cost-effectiveness. They work closely with healthcare providers, insurance companies, and patients to facilitate approvals or appeals. The goal is to balance quality patient care with cost containment in the healthcare system.

What are popular job titles related to Insurance Utilization Review jobs in Maine?

For Insurance Utilization Review jobs in Maine, the most frequently searched job titles are:

What job categories do people searching Insurance Utilization Review jobs in Maine look for?

The top searched job categories for Insurance Utilization Review jobs in Maine are:

Insurance Utilization Review jobs near you
Infographic showing various Insurance Utilization Review job openings in Maine as of July 2026, with employment types broken down into 83% Full Time, and 17% Contract. Highlights an 83% In-person, and 17% Remote job distribution, with an average salary of $85,150 per year, or $40.9 per hour.

Travel Nurse RN - $2,428 per week in York, ME

TravelNurseSource

York, ME • On-site

$2.4K/wk

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

Registered Nurse (RN) | Other Location: York, ME Agency: Prime Staffing Pay: $2,428 per week Shift Information: Days - 5 days x 10 hours Contract Duration: 13 Weeks Start Date: ASAP

About the Position

TravelNurseSource is working with Prime Staffing to find a qualified Other RN in York, Maine, 03909!
ID: 63682080 Shift: Variable 8 - 4:30 pm or 4 - 10 hour shifts of 7:30 am to 5:00 pm - No Call - Weekend and Holiday Ro Description: At York Hospital, we're more than a hospital. We are a team of providers, clinicians and staff members offering expertise within a Hospital setting, our community sites, and physician practices located throughout Southern Maine and the NH seacoast. Our caregivers' commitment is to make a positive difference in the lives of one another, our patients and our community by instilling our vision of Loving Kindness for all. We currently have an opportunity for two experienced RN Care Manager for a 13 week assignment at our main campus in York, Maine. These are 40 hour per week positions with variable shifts of either 8:30 to 4:30 or four ten (10) hour shifts that will start at 7:30 am - 5:00 pm . There is no call, but weekend and holiday rotation is required. The RN Care Manager will coordinate concurrent utilization management activities house-wide and is the main link between the patient, health care team, organization, and payors during the patient's hospital stay. Duties and Responsibilities: Ability to conduct an assessment of patient needs, identify resources required to transition patients to the next setting, and secure the necessary resources. Collaborate, educate, and lead an interdisciplinary team of professionals in daily care rounds/care conferences/care planning. Excellent communication skills in written, verbal, and electronic systems such as email or with software applications currently used with the hospital. Ability to work with community organizations to secure durable medical equipment, health insurance authorizations, arrange transportation. Participate in the length of stay of an inpatient hospital population. Knowledge of hospital reimbursement methods and quality measures applicable to the care management department. Education/Licensure/Certifications/Qualifications: Associate or Bachelor degree-prepared Registered Nurse with 3-5 years clinical experience in medical/surgical nursing, home care, hospital case management and/or previous utilization review experience. Must have utilization reveiw and discharge planning experience. Certification by a nationally recognized case management or utilization review organization preferred Must have active BLS. CCM or ACM preferred. Additional Information:If timecards are not filled out properly, they will be rejected and not processed. Please see timecard rules file, uploaded in Medefis. Position Billing string = Medefis Guaranteed Hours: 40 Contract Weeks:91

About Prime Staffing

At Prime Staffing, we understand the importance of finding the perfect fit for both our clients and candidates. Prime Staffing utilizes a unique matchmaking approach, providing the most qualified contingent staffing to our clients, and the most competitive contracts to our workforce. Our experienced team takes the time to get to know both our clients and candidates, their needs, and preferences, to ensure that each placement is a success.

We offer a wide range of staffing services including temporary, temp-to-perm, and direct hire placements. Our extensive network of qualified candidates includes nurses, allied healthcare professionals, corporate support professionals and executives.

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