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Utilization Review Rn Jobs in Maine (NOW HIRING)

IU Health Methodist University

RN - Case Management

Biddeford, ME · On-site

$2.3K/wk

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Conduct Utilization Review activities. * Manage a caseload effectively to ensure efficiency in ... Current RN licensure with 4-5 years of nursing experience. * Minimum of 3 years of acute clinical ...

American Traveler

Travel RN Care Manager

Portland, ME · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

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 ...

American Traveler

Travel Care Manager

Portland, ME · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

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 ...

UnitedHealth Group

Case Manager RN

Bangor, ME · On-site

$60K - $107K/yr

  • Retirement

Maintains a working knowledge of care management, care coordination changes, utilization review ... Current, unrestricted RN license in the state of employment * 3+ years of experience in a hospital ...

UnitedHealth Group

Case Manager RN

Bangor, ME

$60K - $107K/yr

  • Retirement

Maintains a working knowledge of care management, care coordination changes, utilization review ... Current, unrestricted RN license in the state of employment * 3+ years of experience in a hospital ...

UnitedHealth Group

Case Manager RN

Bangor, ME

$60K - $107K/yr

  • Retirement

Maintains a working knowledge of care management, care coordination changes, utilization review ... Current, unrestricted RN license in the state of employment * 3 years of experience in a hospital ...

UnitedHealth Group

Care Manager RN - Per Diem

Portland, ME

$28.27 - $50.48/hr

  • Retirement

Maintains a working knowledge of care management, care coordination changes, utilization review ... Current, unrestricted RN license in the state of employment * 1+ years of experience in a hospital ...

UnitedHealth Group

Care Manager RN - Per Diem

Portland, ME · On-site

$28.27 - $50.48/hr

  • Retirement

The Care Manager RN - Per Diem provides leadership in the coordination of patient-centered care ... Maintains a working knowledge of care management, care coordination changes, utilization review ...

UnitedHealth Group

Care Manager RN - Per Diem

Portland, ME

$28.27 - $50.48/hr

  • Retirement

The Care Manager RN - Per Diem provides leadership in the coordination of patient-centered care ... Maintains a working knowledge of care management, care coordination changes, utilization review ...

CVS Health

Case Manager, Registered Nurse

Sanford, ME · On-site

$54K - $155K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

A RN who resides in a compact state is required to have an active multistate license through the ... Utilization Review. * CCM and/or other URAC recognized accreditation preferred. * 1+ years ...

CVS Health

Utilization Management Nurse Consultant-1

Sanford, ME · On-site

$26.01 - $74.78/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Must have active current and unrestricted RN licensure in state of residence * Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours * This ...

New

Elevance Health

Clinical Review Nurse II (US)

South Portland, ME · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Current unrestricted RN license required. * This position is part of our Wellpoint Federal division ... Medical management or Utilization Review experience is preferred. For candidates working in person ...

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Showing results 21-40

All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Maine

Utilization Review Rn information

See Maine salary details

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$66

How much do utilization review rn jobs pay per hour?

As of Aug 17, 2026, the average hourly pay for utilization review rn 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 utilization review RN?

A Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services and treatments provided to patients. They review medical records, collaborate with healthcare teams, and ensure that patient care meets established guidelines and payer requirements. Their role helps control costs, optimize care, and support compliance with healthcare regulations. Utilization Review RNs often work in hospitals, insurance companies, or managed care organizations.

How does a utilization review RN collaborate with physicians and other healthcare professionals during the patient care review process?

A Utilization Review RN works closely with physicians, case managers, and other healthcare team members to ensure that patients receive appropriate care while adhering to regulatory and insurance guidelines. This collaboration often involves discussing clinical findings, clarifying documentation, and negotiating care plans to meet both patient needs and payer requirements. Effective communication and teamwork are essential, as Utilization Review RNs frequently serve as liaisons between clinical staff and insurance representatives to facilitate timely authorizations and prevent unnecessary delays in patient care.

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

To thrive as a Utilization Review RN, you need a current RN license, strong clinical assessment skills, and knowledge of healthcare regulations and insurance guidelines. Familiarity with utilization management software, electronic health records (EHRs), and relevant certifications like CCM or ACM is often required. Excellent critical thinking, communication, and negotiation skills help you advocate for appropriate patient care while collaborating with providers and payers. These skills ensure cost-effective, quality care and compliance with regulatory standards in healthcare delivery.

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

AspectUtilization Review RnCase Manager
CredentialsRN license, certifications in utilization reviewRN license, certifications in case management
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, community agencies, insurance companies
Primary FocusReviewing medical necessity and appropriateness of careCoordinating patient care and discharge planning

Utilization Review Rns primarily focus on evaluating the necessity of medical treatments, while Case Managers coordinate patient care and discharge planning. Both roles require RN licensure and certifications, but their daily responsibilities and work environments differ slightly, with Utilization Review Rns concentrating on review processes and Case Managers on patient advocacy and care coordination.

How to get into utilization review as a registered nurse?

To become a utilization review RN, you typically need a valid registered nurse license and experience in clinical settings. Additional certifications such as the Certified Professional in Healthcare Quality (CPHQ) or case management certification can enhance job prospects, and familiarity with electronic health records (EHR) systems is often required.

What are the most commonly searched types of Utilization Review Rn jobs in Maine?

The most popular types of Utilization Review Rn jobs in Maine are:

What are popular job titles related to Utilization Review Rn jobs in Maine?

For Utilization Review Rn jobs in Maine, the most frequently searched job titles are:

What job categories do people searching Utilization Review Rn jobs in Maine look for?

The top searched job categories for Utilization Review Rn jobs in Maine are:

What are popular job titles related to Utilization Review Rn jobs in ME?

For Utilization Review Rn jobs in ME, the most frequently searched job titles are:

Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn 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.

Travel RN Case Manager - $2,509 per week

American Traveler

Biddeford, ME • On-site

$2.5K/wk

Other

Medical, Dental, Vision, Life, Retirement

Posted 5 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 seeking an experienced RN Case Manager for a 13-week travel assignment focused on care coordination, discharge planning, and utilization review, requiring prior travel Case Management experience.

Details
  • Position based in the Case Management department of a medical center
  • Focus on care coordination, discharge planning, and utilization review
  • Day shift schedule, 40 hours per week, 7:30 AM - 4:00 PM
  • Every third weekend required, 7:30 AM - 4:00 PM
  • 13-week contract assignment
  • Uses Epic EMR
  • Float policy of 25 miles between facilities as needed
Requirements
  • Active RN license (Maine or Compact) required
  • BLS or other AHA certifications required by start date if not already held
  • Minimum 4-5 years of RN experience required
  • At least 3 years of acute clinical experience required, in addition to Case Management experience
  • Prior travel assignment experience required; this is not suitable for first-time travelers
  • 2-3 prior Case Management travel assignments preferred
  • Driver's License required for consideration
  • 2 professional references required
Additional Information
  • Responsible for care coordination, discharge planning, and utilization review for assigned patient caseload
  • Local candidates within 90 miles of any MaineHealth facility will be considered local, with adjusted bill rate
  • Local travelers are not eligible for renewals or extensions
  • Candidates who have worked at any MaineHealth facility within the past 12 months should disclose this during consideration
  • RTO should be kept to a minimum, with 3-4 days considered reasonable for the 13-week contract at manager's discretion
  • 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.

Why Vivian Health?

Be sure to apply via Vivian Health to increase your chances of landing your perfect job. Just complete your Vivian Health profileonce, and get access to thousands of opportunities across the country. Then keep up to date with your job application process and conversations with our easy to use app.

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