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Remote Utilization Review Rn Jobs in Sanford, ME

Clinical Intake Coordinator

Portland, ME · On-site +1

$60K - $80K/yr

This is a remote position designed to support and scale virtual services across the organization ... Registered Nurse certified as a Psychiatric Nurse, b. Advanced Practice Registered Nurse (APRN) ...

Clinical Intake Coordinator

Portland, ME · On-site +1

$60K - $80K/yr

This is a remote position designed to support and scale virtual services across the organization ... Registered Nurse certified as a Psychiatric Nurse, b. Advanced Practice Registered Nurse (APRN) ...

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Remote Utilization Review Rn information

See Sanford, ME salary details

$20

$40

$66

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

As of Jul 31, 2026, the average hourly pay for remote utilization review rn in Sanford, ME is $40.48, according to ZipRecruiter salary data. Most workers in this role earn between $31.97 and $46.49 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Remote Utilization Review RN, and why are they important?

To excel as a Remote Utilization Review RN, you need a valid RN license, strong clinical judgment, and knowledge of utilization management principles. Familiarity with electronic medical records (EMR), utilization management software, and guidelines such as InterQual or MCG is typically required. Outstanding attention to detail, critical thinking, and effective communication skills help you collaborate with healthcare teams and advocate for appropriate patient care. These competencies are crucial for ensuring medical necessity, regulatory compliance, and optimal resource use in a remote setting.

What is a Remote Utilization Review RN?

A Remote Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services provided to patients, typically working from a remote location. They review medical records, apply clinical guidelines, and collaborate with healthcare providers to ensure patients receive the right care at the right time. Their work helps manage healthcare costs and improves patient outcomes by preventing unnecessary treatments or hospital stays. Remote Utilization Review RNs often work for insurance companies, hospitals, or healthcare organizations, and use secure digital platforms to conduct their reviews.

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

AspectRemote Utilization Review RnRemote Case Manager Rn
CertificationsRN license, Utilization Review certification (e.g., URAC)RN license, Case Management certification (e.g., CCM)
Work EnvironmentReviewing medical records, insurance policies, telehealth platformsCoordinating patient care, discharge planning, telehealth
Employer & IndustryInsurance companies, healthcare organizationsHospitals, insurance providers, healthcare agencies

Remote Utilization Review Rns primarily focus on evaluating medical necessity for insurance coverage, while Remote Case Manager Rns coordinate patient care and discharge planning. Both roles require RN licensure and involve telehealth work, but they serve different functions within healthcare and insurance industries.

What are some common challenges Remote Utilization Review RNs face when working from home, and how can they be addressed?

Remote Utilization Review RNs often encounter challenges such as maintaining clear communication with interdisciplinary teams, managing time efficiently, and staying updated on changing payer guidelines. To address these challenges, it's important to establish consistent check-ins with team members via video or chat platforms, use digital tools to organize and prioritize caseloads, and participate in ongoing training sessions provided by employers. Adhering to a structured daily routine and leveraging available technology can help ensure productivity and high-quality reviews while working remotely.
What are popular job titles related to Remote Utilization Review Rn jobs in Sanford, ME? For Remote Utilization Review Rn jobs in Sanford, ME, the most frequently searched job titles are:
What cities near Sanford, ME are hiring for Remote Utilization Review Rn jobs? Cities near Sanford, ME with the most Remote Utilization Review Rn job openings:
Infographic showing various Remote Utilization Review Rn job openings in Sanford, ME as of July 2026, with employment types broken down into 72% Full Time, 11% Part Time, and 17% Contract. Highlights an 42% Physical, 2% Hybrid, and 56% Remote job distribution, with an average salary of $84,196 per year, or $40.5 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 27 days ago


Maximus rating

6.8

Company rating: 6.8 out of 10

Based on 300 frontline employees who took The Breakroom Quiz

289th of 479 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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