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Utilization Review Manager Jobs in Denmark, ME (NOW HIRING)

Lakewood

Director of Nursing (DON)

West Baldwin, ME · On-site

Review and analyze facility activities and data to aid planning and cash and risk management and to improve service utilization. * Prepare activity reports to inform management of the status and ...

Chico's FAS

Sales Associate - Chico's

East Wakefield, NH

$13.75 - $18.75/hr

The Sales Associate is responsible for supporting Management in in promoting a customer and product ... When we do have an open position, we will review your application to determine if your ...

Chico's FAS, Inc.

Sales Associate - Chico's

Conway, NH · On-site

$13.75 - $18.75/hr

The Sales Associate is responsible for supporting Management in in promoting a customer and product ... When we do have an open position, we will review your application to determine if your ...

Huggins Hospital

Gynecologist

Wolfeboro, NH · On-site

$254K - $274K/yr

Record Utilization: • Utilizes the current Electronic Medical Record to complete the documented ... For further information, please review the Know Your Rights notice from the Department of Labor.

Huggins Hospital

Gynecologist

Wolfeboro, NH · On-site

$254K - $274K/yr

Record Utilization: • Utilizes the current Electronic Medical Record to complete the documented ... For further information, please review the Know Your Rights notice from the Department of Labor.

Chico's FAS, Inc.

Sales Lead - Chico's

Conway, NH · On-site

The Sales Lead is responsible for supporting Management in in promoting a customer and product ... Ensures team maintains consistent client communication through utilization of customer book ...

Prime Healthcare

Chief of Hospital Medicine

Lewiston, ME · On-site

$355K - $384K/yr

Partner with Medical Staff leadership and Human Resources on performance management, peer review ... Support budget development, productivity expectations, and resource utilization for Hospital ...

Estes Express Lines

Dock Supervisor

Lewiston, ME · On-site

... Manager * Responsible for meeting all KPI's assigned * Daily utilization of all Company enhancement tools and processes * Review and revise schedules to increase efficiencies and to lower cost

Estes Express Lines

Dock Supervisor

Lewiston, ME · On-site

... Manager * Responsible for meeting all KPI's assigned * Daily utilization of all Company enhancement tools and processes * Review and revise schedules to increase efficiencies and to lower cost

Estes Express Lines

Dock Supervisor

Lewiston, ME · On-site

... Manager * Responsible for meeting all KPI's assigned * Daily utilization of all Company enhancement tools and processes * Review and revise schedules to increase efficiencies and to lower cost

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Showing results 41-60

All JobsUtilization Review JobsUtilization Review Manager JobsUtilization Review Manager Jobs in Denmark, ME

Utilization Review Manager information

See Denmark, ME salary details

$40.4K

$94.2K

$173.4K

How much do utilization review manager jobs pay per year?

As of Aug 12, 2026, the average yearly pay for utilization review manager in Denmark, ME is $94,225.00, according to ZipRecruiter salary data. Most workers in this role earn between $61,600.00 and $113,400.00 per year, depending on experience, location, and employer.

Is utilization review a stressful job?

Utilization review managers oversee the assessment of healthcare services to ensure appropriate and efficient care, which can involve high workloads and strict deadlines, leading to stress. The job requires strong organizational skills, attention to detail, and the ability to handle complex cases, which may contribute to job-related stress for some individuals.

What are some common challenges faced by utilization review managers in balancing patient care and cost efficiency?

Utilization Review Managers often encounter the challenge of ensuring patients receive appropriate care while also adhering to insurance and regulatory guidelines that emphasize cost efficiency. This requires strong analytical skills to assess clinical information and make fair determinations, often under tight deadlines and with incomplete data. The role also involves frequent communication with physicians, payers, and case managers to resolve disagreements and clarify criteria, making negotiation and diplomacy essential. Staying updated on changing healthcare regulations and payer requirements can add to the complexity, but it also provides opportunities for professional growth and leadership within healthcare administration.

What are the key skills and qualifications needed to thrive as a utilization review manager?

To thrive as a Utilization Review Manager, you need a solid background in healthcare management, clinical knowledge (often as an RN or healthcare professional), and experience with utilization review processes. Familiarity with case management software, electronic health records (EHRs), and certifications such as Certified Case Manager (CCM) or Certified Professional in Utilization Review (CPUR) are often expected. Strong analytical thinking, attention to detail, leadership, and effective communication are crucial soft skills for success in this role. These skills ensure appropriate resource use, regulatory compliance, and coordinated patient care, which are vital for both healthcare quality and operational efficiency.

What is the difference between Utilization Review Manager vs Utilization Review Coordinator?

AspectUtilization Review ManagerUtilization Review Coordinator
CertificationsTypically requires certifications like CCM or ACUMay require similar certifications but often less advanced
Work EnvironmentSupervises review teams, manages processes in healthcare or insurance settingsPerforms case reviews, supports the review process under supervision
Employer & IndustryHospitals, insurance companies, healthcare organizationsInsurance companies, healthcare providers, third-party administrators

The Utilization Review Manager oversees review teams and manages utilization review processes, focusing on policy compliance and efficiency. The Utilization Review Coordinator supports the review process by conducting case assessments and assisting managers. While both roles require similar certifications and work in related environments, the manager holds a supervisory position with broader responsibilities.

What does a utilization review manager do?

A Utilization Review Manager oversees the process of evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. They ensure that patient care adheres to established guidelines and that healthcare resources are used effectively. Their duties typically include leading a team of reviewers, collaborating with healthcare providers, ensuring compliance with regulations, and making recommendations on care authorization. The goal is to balance quality patient care with cost-effective resource management.
What are the most commonly searched types of Utilization Review jobs in Denmark, ME? The most popular types of Utilization Review jobs in Denmark, ME are:
What job categories do people searching Utilization Review Manager jobs in Denmark, ME look for? The top searched job categories for Utilization Review Manager jobs in Denmark, ME are:
What cities near Denmark, ME are hiring for Utilization Review Manager jobs? Cities near Denmark, ME with the most Utilization Review Manager job openings:
Utilization Review Manager jobs near you
Infographic showing various Utilization Review Manager job openings in Denmark, ME as of July 2026, with employment types broken down into 1% As Needed, 85% Full Time, 13% Part Time, and 1% Contract. Highlights an 85% Physical, 2% Hybrid, and 13% Remote job distribution, with an average salary of $94,225 per year, or $45.3 per hour.

Director of Nursing (DON)

Lakewood - Americare

West Baldwin, ME • On-site

$95K - $123K/yr

Full-time

Medical, Dental, Vision, Life, PTO

Posted 5 days ago

Job description

Director of Nursing Job Summary
As a director of nursing (DON) you plan, organize, develop, and direct the overall operations of the Nursing Services department to ensure the highest degree of quality resident care in accordance with all laws, regulations, and Company standards.
What we are looking for in our amazing candidates:
STAFF DEVELOPMENT
  • Direct, supervise, and evaluate work activities of nursing personnel
  • Recruit, select, hire, train, evaluate, counsel, and supervise nursing staff
  • Coach and develop staff, engaging in the growth of your leadership team
  • Plan, develop, organize, implement, evaluate, establish benchmarks, and direct professional and non-professional staff
  • Develop and implement organizational policies and procedures for the facility or medical unit
  • Develop instructional materials and conduct in-service and community-based educational programs

PROFESSIONAL
  • Maintain awareness of advances in medicine, computerized diagnostic and treatment equipment, data processing technology, government regulations, health insurance changes, and financing options
  • Consult with medical, business, and community groups to discuss service problems, respond to community needs, enhance public relations, coordinate activities and plans, and promote health programs
  • Develop or expand and implement medical programs or health services that promote research, rehabilitation, and community health
  • Communicate effectively with physicians, nursing staff, and other professional and non-professional staff
  • Knowledgeable of nursing practices and procedures as well as the laws, regulations, and guidelines governing nursing functions in the long-term care facility
  • Understand and follow company policies, including harassment and complaint procedures
  • Maintain skills in order to provide direct nursing care as necessary

OPERATIONS
  • Conduct and administer fiscal operations, including accounting, planning budgets, authorizing expenditures, establishing rates for services, and coordinating financial reporting
  • Plan, organize, develop, implement, and interpret the programs, goals, objectives, policies, and procedures of the Nursing Services department
  • Review and analyze facility activities and data to aid planning and cash and risk management and to improve service utilization
  • Prepare activity reports to inform management of the status and implementation plans of programs, services, and quality initiatives
  • Use of diagnostic services, inpatient beds, facilities, and staff to ensure effective use of resources and assess the need for additional staff, equipment, and services
  • Develop and maintain computerized record management systems to store and process data such as personnel activities and information, and to produce reports
  • Inspect facilities and recommend building or equipment modifications to ensure emergency readiness and compliance to access, safety, and sanitation regulations
  • Work with leadership team to establish appropriate level of CNAs and LPNs per shift based upon budgeted NHPPD

Skills and abilities
  • Experience: Two to four years of related nursing and leadership experience
  • Excellent communications skills, written and verbal
  • Solid computer skills - both personal computer and electronic medical record
  • Strong leadership skills, ability to develop new strengths and skills
  • Analytical skills and abilities to turn data into action; moving your facility forward
  • Strong reasoning skills, good judgment, and critical thinking skills

Requirements:
  • Currently a registered nurse /licensed in Maine
  • CPR Certification upon hire or obtain it during orientation. CPR certification must remain current during employment

Benefits:
  • Tuition reimbursement
  • Full time employees have access to full benefits; medical, dental, vision, and disability
  • Employer paid life insurance
  • Flexible savings account, including medical & dependent care
  • Paid Time Off available to all employees
  • Annual Performance Bonus

As part of a strong clinical team, providing amazing care and support to our Residents, we invest in your future and allow for the ability to grow and build a career with us.

Apply