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Remote Rn Utilization Review Nurse Jobs in Maine

$81K - $109K/yr

Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500009 Utilization Management ... Maintains knowledge of hospital clinical practice guidelines to support the most thorough review of ...

$81K - $109K/yr

Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 500009 Utilization Management ... Maintains knowledge of hospital clinical practice guidelines to support the most thorough review of ...

Remote Adjunct - FNP/PMHNP/AGACNP Nursing

ME · On-site +1

$112K - $142K/yr

Meet with the Program Director at the end of each semester to review course evaluations and provide ... Active unencumbered United States RN licensure. * Active unencumbered United States Advanced ...

Clinical Care Rep RN

South Portland, ME · On-site +1

$33.34 - $48.31/hr

Unencumbered active registered nurse or LPN licensure in state of Maine * Previous experience in a ... For further information, please review the Know Your Rights notice from the Department of Labor.

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Showing results 1-20

Remote Rn Utilization Review Nurse information

See Maine salary details

$20

$40

$66

How much do remote rn utilization review nurse jobs pay per hour?

As of Aug 17, 2026, the average hourly pay for remote rn utilization review nurse 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 is a Remote RN Utilization Review Nurse?

A Remote RN Utilization Review Nurse is a registered nurse who evaluates medical records and healthcare services from a remote location to ensure that patients receive appropriate, necessary, and cost-effective care. They review treatment plans, check for compliance with insurance and healthcare guidelines, and often work with healthcare providers, insurance companies, and patients to coordinate care. This role typically involves assessing the medical necessity of procedures, authorizing services, and helping prevent unnecessary treatments or hospitalizations.

What are the key skills and qualifications needed to thrive as a Remote RN Utilization Review Nurse?

To thrive as a Remote RN Utilization Review Nurse, you need an active RN license, strong clinical knowledge, and experience in case management or utilization review. Proficiency with healthcare review software, electronic health records (EHRs), and familiarity with insurance guidelines or regulatory requirements is vital. Excellent communication, critical thinking, and time management skills distinguish top performers in remote settings. These skills enable nurses to make accurate, timely decisions about patient care while ensuring compliance and efficient resource utilization.

What are some common challenges faced by Remote RN Utilization Review Nurses, and how can they be addressed?

Remote RN Utilization Review Nurses often encounter challenges such as managing large caseloads, maintaining effective communication with interdisciplinary teams, and staying updated with ever-changing insurance guidelines. Balancing productivity expectations while ensuring thorough case reviews can be demanding. To address these challenges, nurses can utilize robust organizational tools, participate in ongoing training sessions, and leverage regular virtual meetings to stay connected with colleagues and supervisors, ensuring both efficiency and high-quality patient care.

What is the difference between Remote Rn Utilization Review Nurse vs Remote Rn Case Manager?

AspectRemote Rn Utilization Review NurseRemote Rn Case Manager
CertificationsRN license, possibly UR or CCM certificationRN license, CCM or other case management certification
Work EnvironmentReviewing medical records, insurance guidelines, and authorizationsCoordinating patient care, discharge planning, and resource management
Employer & Industry UsageHealth insurance companies, third-party administratorsHospitals, health plans, healthcare providers

Remote Rn Utilization Review Nurses primarily evaluate medical necessity for insurance approvals, focusing on documentation and guidelines. In contrast, Remote Rn Case Managers coordinate patient care, discharge planning, and resource allocation. Both roles require RN licensure and related certifications but differ in daily tasks and work focus.

Infographic showing various Remote Rn Utilization Review Nurse job openings in Maine as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 13% Part Time, 3% Temporary, 2% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $85,150 per year, or $40.9 per hour.

RN Clinical Assessor - (Hybrid Remote - Westbrook, Maine)

Maximus

Westbrook, ME • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 15 days ago


Maximus rating

6.8

Company rating: 6.8 out of 10

Based on 300 frontline employees who took The Breakroom Quiz

291st of 492 rated business services


Job description

General information
Job Posting Title
RN Clinical Assessor - (Hybrid Remote - Westbrook, Maine)
Date
Thursday, June 4, 2026
City
Westbrook
State
ME
Country
United States
Working time
Full-time
Description & Requirements
Maximus is seeking a Registered Nurse, Clinical Assessor to join our growing team. As a Nurse Assessor, you will conduct person-centered assessments in accordance with contract directives, company processes, and contract requirements.
You'll evaluate individuals in their homes, group homes, and care facilities to determine Long Term Care needs and appropriate placement options.
This position requires the ability to commute within and cover Cumberland county.
About the program: Maximus has been contracted to partner with the State of Maine's Department of Health and Human Services, through the Office of Aging and Disability (OADS), as manager of its Statewide Assessing Services. This single Assessing Services Agency (ASA) Program will encompass a series of programs, including Long Term Care (LTC), ABI, ORC, ICF/IDD, GPU.
Why Maximus?
- Work/Life Balance Support - Flexibility tailored to your needs!
- Competitive Compensation - Bonuses based on performance included!
- Comprehensive Insurance Coverage - Choose from various plans, including Medical, Dental, Vision, Prescription, and partially funded HSA. Additionally, enjoy Life insurance benefits and discounts on Auto, Home, Renter's, and Pet insurance.
- Future Planning - Prepare for retirement with our 401K Retirement Savings plan and Company Matching.
- Paid Time Off Package - Enjoy PTO, Holidays, and extended sick leave, along with Short and Long Term Disability coverage.
- Holistic Wellness Support - Access resources for physical, emotional, and financial wellness through our Employee Assistance Program (EAP).
- Recognition Platform - Acknowledge and appreciate outstanding employee contributions.
- Tuition Reimbursement - Invest in your ongoing education and development.
- Employee Perks and Discounts - Additional benefits and discounts exclusively for employees.
- Maximus Wellness Program and Resources - Access a range of wellness programs and resources tailored to your needs.
- Professional Development Opportunities-Participate in training programs, workshops, and conferences.
- Licensures and Certifications-Maximus assumes the expenses associated with renewing licenses and certifications for its employees.
Essential Duties and Responsibilities:
- Responsible for completing medical and/or behavioral health assessments within contract requirements
- Conducts on-site, video call and/or telephonic assessments to determine an individual's needs for services and supports, eligibility, level of care or related outcome
- Perform all job duties in compliance with Person First standards, HIPAA guidelines, and company confidentiality policies and procedures.
- Travel may be required based on program contract requirements
- Performs other related duties as assigned.
Minimum Requirements
- Current Registered Nurse (RN) license valid in the state of practice is required
- High School Degree or equivalent required
- Minimum 1 year of clinical experience required
-Minimum two (2) years of post graduate nursing experience
Preferred Requirements
-Experience in long term care or home health care
-Experience with OASIS or MDS
Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
*Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
*Minimum 5 Mpbs upload speeds
- Private and secure workspace
#ClinicalServices #LI-Hybrid
EEO Statement
Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.
Accommodations
Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at applicantaccom@maximus.com.
Minimum Salary
$
30.00
Maximum Salary
$
35.00

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