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

Pharmacy Careers

Remote Clinical Review Pharmacist

Portland, ME · On-site

$123K - $146K/yr

Remote Clinical Review Pharmacist - Work From Home | Evidence-Based Decisions | Flexible Schedule ... Collaborate with physicians, nurses, and utilization-management teams on complex cases. * Document ...

New

Business Integra LLC

RN Unit Manager

Falmouth, ME · On-site

$39 - $51.25/hr

Perform utilization management and review functions to ensure appropriate care levels and resource use. * Evaluate medical necessity and level of care based on clinical criteria and payer guidelines.

Dane Street, LLC

Board-Certified Neurologist

Portland, ME · On-site

$327K - $409K/yr

Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams

Dane Street, LLC

Board-Certified Neurologist

Portland, ME

$327K - $409K/yr

Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams

Dane Street, LLC

Board-Certified Neurologist

Portland, ME · On-site

$327K - $409K/yr

Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams

Dane Street

Board-Certified Neurologist

Portland, ME · On-site

$332K - $415K/yr

Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams

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

Utilization Review Manager information

See Portland, ME salary details

$38.2K

$89K

$163.9K

How much do utilization review manager jobs pay per year?

As of Aug 11, 2026, the average yearly pay for utilization review manager in Portland, ME is $89,044.00, according to ZipRecruiter salary data. Most workers in this role earn between $58,200.00 and $107,100.00 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 Portland, ME? The most popular types of Utilization Review jobs in Portland, ME are:
What are popular job titles related to Utilization Review Manager jobs in Portland, ME? For Utilization Review Manager jobs in Portland, ME, the most frequently searched job titles are:
What job categories do people searching Utilization Review Manager jobs in Portland, ME look for? The top searched job categories for Utilization Review Manager jobs in Portland, ME are:
What cities near Portland, ME are hiring for Utilization Review Manager jobs? Cities near Portland, ME with the most Utilization Review Manager job openings:
Utilization Review Manager jobs near you
Infographic showing various Utilization Review Manager job openings in Portland, ME as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 21% Part Time, and 1% Contract. Highlights an 93% Physical, 3% Hybrid, and 4% Remote job distribution, with an average salary of $89,044 per year, or $42.8 per hour.

Travel Nurse RN - Case Manager, Utilization Review

AMN Healthcare Revenue Cycle

Portland, ME • On-site

$1.8K - $2.7K/wk

Contractor

Medical, Dental, Vision, Life, Retirement

This job post has expired 2 days ago. Applications are no longer accepted.

Job description

AMN Healthcare Revenue Cycle is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Portland, Maine.

Job Description & Requirements
  • Specialty: Utilization Review
  • Discipline: RN
  • Start Date: 08/31/2026
  • Duration: 13 weeks
  • 36 hours per week
  • Shift: 12 hours
  • Employment Type: Travel

Job Description & Requirements
RN Case Manager
StartDate: 8/31/2026 Pay Rate: $1800.00 - $2700.00

POSITION SUMMARY – RN Case Manager

POSITION DUTIES – Coordinate patient care from admission through discharge, ensuring that treatments, services, and resources align with each patient’s medical needs and recovery goals. Collaborate closely with physicians, nurses, and external providers to remove barriers to care, streamline transitions, and support safe, efficient discharge planning.

MINIMUM REQUIRED QUALIFICATIONS –

  • ME/compact RN license
  • BLS
  • 2+ years recent case management experience in an acute hospital setting
  • Skilled experience in discharge planning and care coordination

PREFERRED QUALIFICATIONS – 5+ years recent case management experience in an acute hospital setting

LENGTH OF ASSIGNMENT – 12 weeks

SHIFT / HOURS PER WEEK – 7:30a-4p. Occasional weekend hours available but not required.

SYSTEMS – Epic

START DATE – ASAP


Facility Location
With its scenic coastline, sea-battered lighthouses and quaint seaside neighborhoods, Portland has it all. Whether you want to indulge in freshly caught lobster, visit historic inns, explore secluded bays and harbors, or simply walk along a seaside cliff and feel the salty ocean breeze in your hair, Portland can make it all happen.
Job Benefits
Becoming an AMN Healthcare professional gives you the incredible opportunity to gain critical career experience, work with new people, and earn a highly competitive salary—but the perks don't stop there. There are many additional benefits to enjoy, including:
  • Medical, dental and vision benefits
  • Earned time off and paid holidays
  • Paid continuing education time
  • 401(K) retirement planning
  • Short-term disability, life insurance, paid jury duty
  • Access to the largest network of facilities and providers in the country
  • Industry experienced workforce management team
  • Licensure and certification reimbursement

About the Company
At AMN Healthcare, we strive to be recognized as the most trusted, innovative, and influential force in helping healthcare organizations provide quality patient care that continually evolves to make healthcare more human, more effective, and more achievable.

AMN Healthcare Revenue Cycle Job ID #3556965. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: RN Case Manager

About AMN Healthcare Revenue Cycle

AMN Healthcare is a leading force in the healthcare industry, committed to being the most trusted, innovative, and influential partner for healthcare organizations. With a focus on providing quality patient care, AMN Healthcare offers holistic solutions that reduce costs, streamline processes, and improve efficiencies. The company boasts over 30 years of experience and takes pride in staffing leading healthcare facilities with the nation's best travelers. As an industry leader, AMN Healthcare offers a diverse team dedicated to supporting healthcare workers and facilities, ensuring a personalized and supportive experience for both clients and candidates.

Benefits
  • Medical benefits
  • Dental benefits
  • Company provided housing options
  • Continuing Education

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