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Utilization Review Case Manager Jobs in Wells, ME

GQR Global Markets

RN Case Manager

Biddeford, ME · On-site

$2.2K - $2.3K/wk

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Biddeford, Maine Start Date: May 11, 2026 Profession: Registered Nurse (RN) Facility: Estimated Pay: $2234.88 ...

Encompass Health

Case Manager

Portland, ME · On-site

$20.50 - $26.25/hr

Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * License or ...

Encompass Health

Case Manager

Portland, ME

$20.50 - $26.25/hr

Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications License or Certification:

Encompass Health Corporation

Case Manager

Portland, ME · On-site

$20.25 - $26/hr

Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * License or ...

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Utilization Review Case Manager information

See Wells, ME salary details

$17

$38

$63

How much do utilization review case manager jobs pay per hour?

As of Aug 23, 2026, the average hourly pay for utilization review case manager in Wells, ME is $38.43, according to ZipRecruiter salary data. Most workers in this role earn between $31.15 and $40.53 per hour, depending on experience, location, and employer.

What is a utilization review case manager?

A Utilization Review Case Manager is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical treatments and services provided to patients. They review clinical information, coordinate with providers and insurance companies, and ensure that patient care aligns with established guidelines and policies. Their goal is to optimize patient outcomes while managing healthcare costs and ensuring compliance with regulations.

What are some common challenges utilization review case managers face when coordinating care across multiple departments?

Utilization Review Case Managers often navigate complex communication between physicians, nursing staff, insurance providers, and patients to ensure appropriate care and resource use. Balancing timely authorizations with evolving patient needs and varying documentation standards can be challenging. Additionally, staying current with changing regulations and payer requirements requires ongoing learning and adaptability. Building strong collaborative relationships and maintaining clear, concise documentation are key strategies for overcoming these hurdles.

What are the key skills and qualifications needed to thrive as a utilization review case manager, and why are they important?

To thrive as a Utilization Review Case Manager, you need a clinical background such as an RN or LCSW license, strong knowledge of medical necessity criteria, and experience with case management. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of regulatory guidelines like Medicare and Medicaid are essential. Excellent communication, critical thinking, and negotiation skills help facilitate collaboration between patients, providers, and payers. These skills ensure appropriate resource use, compliance with regulations, and high-quality patient care.

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

AspectUtilization Review Case ManagerUtilization Review Nurse
CredentialsTypically requires a nursing license or relevant healthcare certificationRegistered Nurse (RN) license is required
Work EnvironmentOffice-based, insurance companies, healthcare organizationsHospital, clinic, insurance review departments
Primary FocusReviewing medical necessity, coordinating care, managing casesAssessing medical records, clinical review, patient care evaluation

Both roles involve healthcare review and require nursing credentials, but the Utilization Review Case Manager often focuses on coordinating care and managing cases, while the Utilization Review Nurse emphasizes clinical assessment and review of medical records. Understanding these differences helps in choosing the right career path or job search focus.

What cities near Wells, ME are hiring for Utilization Review Case Manager jobs?

Cities near Wells, ME with the most Utilization Review Case Manager job openings:

Utilization Review Case Manager jobs near you
Infographic showing various Utilization Review Case Manager job openings in Wells, ME as of August 2026, with employment types broken down into 50% Full Time, and 50% Contract. Highlights an 100% In-person job distribution, with an average salary of $79,934 per year, or $38.4 per hour.

Travel RN Case Manager

American Traveler

Biddeford, ME • On-site

Contractor

Medical, Dental, Vision, Life, Retirement

Posted 12 days ago

Job description

American Traveler is seeking a travel nurse RN Case Management for a travel nursing job in Biddeford, Maine.

Job Description & Requirements
  • Specialty: Case Management
  • Discipline: RN
  • Start Date: ASAP
  • Duration: 13 weeks
  • 40 hours per week
  • Shift: 8 hours, days
  • Employment Type: Travel
Assignment Overview
  • Shift: Days, 5x8hrs
  • Hours: 40 hrs/wk
  • Start Date: May 11, 2026
  • Length: 13 weeks
  • Openings: 1
Description

American Traveler is hiring an experienced RN Case Manager for a 13-week travel assignment requiring 4-5 years of RN experience and prior case management travel experience.

Details
  • Case Management department within a hospital setting
  • Focus on Care Coordination, Discharge Planning, and Utilization Review
  • 40 hours per week on day shift, 7:30 AM to 4:00 PM
  • Every third weekend required
  • Uses Epic EMR
  • Floating required within a 25-mile radius between facilities as needed
Requirements
  • Active RN license (Maine or Compact) required
  • BLS certification required (AHA-issued certification must be completed prior to start)
  • Minimum 4-5 years of RN experience required
  • At least 3 years of acute clinical experience required, in addition to Case Management experience
  • Minimum 2 years of Case Management experience required
  • Prior travel assignment experience required, with 2-3 completed Case Management travel assignments preferred
  • Valid driver's license required for consideration
  • 2 professional references required
Additional Information
  • Responsibilities include care coordination, discharge planning, and utilization review
  • Department is currently operating with reduced staffing, making this a high-impact role for length of stay management
  • First-time travelers will not be considered for this position
  • Candidates who have worked at this health system within the past 12 months should disclose this during consideration
  • Local candidates residing within 90 miles of any facility within this health system are considered local
  • Local travelers are not eligible for renewals or extensions
  • RTO should be kept to a minimum, with 3-4 days considered reasonable for the 13-week contract
  • Air pods, laptops, and cell phone usage are prohibited on the unit

American Traveler Job ID #P-702150. Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Travel RN - Case Management/Utilization Review - Case Management

About American Traveler

With over 25 years of experience, American Traveler has established a reputation for outstanding customer service. Our team ensures a smooth, worry-free experience for those starting on or expanding their travel nursing and allied careers.

With thousands of travel nursing and allied jobs nationwide, our attentive and approachable recruiters find positions that align perfectly with your career aspirations and personal requirements.

American Traveler offers exceptional benefits, including premium medical, dental, vision and life insurance beginning day one of your assignment, generous 401(k) match, substantial housing stipends, and more. Additionally, with 24/7 support and access to our in-house clinicians, you are assured confidence and comfort throughout your assignment.

With our team behind you, you can relax and enjoy a rewarding travel career.

American Traveler logo

About American Traveler

Sourced by ZipRecruiter

With over 20 years of success in healthcare staffing, American Traveler has established a reputation for outstanding customer service. Our full-service agency has earned top ratings from healthcare professionals in every specialty and setting. We offer travel assignments in the most sought-after locations and facilities in the country. We staff major medical centers, prestigious university teaching facilities, Magnet facilities, regional community hospitals, outpatient centers, rehab centers, skilled nursing facilities and more. With our expert team behind you every step of the way, you can enjoy a rewarding travel career that exceeds your expectations. With over 20 years of experience, American Traveler has established a reputation for outstanding customer service. With our team behind you, you can relax and enjoy a rewarding travel career.

Industry

Recruiting and staffing services

Company size

501 - 1,000 Employees

Headquarters location

Boca Raton, FL, US

Year founded

1999

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