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Utilization Review Rn Jobs in Maine (NOW HIRING)

Northern Light Health

Registered Nurse

Ellsworth, ME · On-site

The Registered Nurse- PDM is a fully competent practitioner of nursing. The incumbent is ... Resource Management - Identifies opportunities to improve utilization of resources. * Professional ...

Northern Light Health

Registered Nurse II

Blue Hill, ME · On-site

Identifies opportunities to improve utilization of resources. Professional Development * Takes ... Actively participates in the peer review process. Performance Improvement * Demonstrates knowledge ...

Entyre Care

Registered Nurse

Lewiston, ME · On-site +1

... a Registered Nurse on our Maine team, supporting family caregivers and ensuring high-quality in ... Review and implement the Authorized Plan of Care provided by the state's Assessing Services Agency

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All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Maine

Utilization Review Rn information

See Maine salary details

$20

$40

$66

How much do utilization review rn jobs pay per hour?

As of Jul 6, 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.

How to get into utilization review as a nurse?

To become a utilization review RN, candidates typically need a valid nursing license and experience in clinical settings. Additional certifications such as Certified Professional in Healthcare Quality (CPHQ) or case management credentials can enhance prospects, and familiarity with electronic health records and insurance policies is beneficial.

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.

How to make $300,000 as a nurse?

A Utilization Review RN can earn $300,000 by gaining extensive experience, obtaining certifications such as Certified Review Officer (CRO), working in high-paying settings like insurance companies or managed care organizations, and taking on leadership or specialized roles that offer higher compensation. Advanced skills in clinical assessment, documentation, and understanding of healthcare policies can also contribute to higher earnings.

What does an RN utilization review do?

An RN utilization review evaluates medical records and treatment plans to determine the necessity, appropriateness, and efficiency of healthcare services. They ensure compliance with insurance policies and clinical guidelines, often using electronic health records and requiring knowledge of coding and documentation standards. This role supports cost-effective patient care and involves collaboration with healthcare providers and insurance companies.

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 make $150,000 as a nurse?

A Utilization Review RN can earn $150,000 by gaining extensive experience, obtaining certifications such as Certified Review Officer (CRO), working in high-demand settings, and possibly taking on leadership or specialized roles. Increasing your workload, working overtime, or pursuing advanced education can also contribute to higher earnings within this field.

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.
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 July 2026, with employment types broken down into 25% Full Time, and 75% Contract. Highlights an 100% In-person job distribution, with an average salary of $85,150 per year, or $40.9 per hour.
Registered Nurse II

Registered Nurse II

Northern Light Health

South Portland, ME • On-site

Part-time

Posted 15 days ago

Northern Light Health rating

6.5

Company rating: 6.5 out of 10

Based on 160 frontline employees who took The Breakroom Quiz

563rd of 877 rated healthcare providers

Job description

Northern Light Home Care and Hospice
Department: Hospice - South Portland
Position is located: Northern Light Home Care & Hospice So Portland
Work Type: Part Time Eligible
Hours Per Week: 16.00
Work Schedule: 8:00 AM to 5:00 PM
Summary:
The Registered Nurse II is a fully competent practitioner of nursing. The incumbent is responsible for the practice of nursing according to the Rules and Regulations defined in the State of Maine Nurse Practice Act, Northern Light Health Standards of Care/Practice, policies and procedures. The Registered Nurse II is responsible for the delivery of patient care to assigned patients, and for the supervision of other qualified staff to whom the Registered Nurse II has delegated patient care in the exercise of his/her independent judgment. The nurse plans and evaluates the nursing care for patients and families and exercises independent judgment in implementing the care him/herself or assigning the care to other qualified staff. The nurse addresses physical, spiritual, emotional and educational needs of the patient, and coordinates the plan of care with other healthcare professionals. The incumbent performs duties and tasks in accordance with performance standards established for the job.
Responsibilities:
  • Patient Safety - Maintains a safe and therapeutic environment by understanding and complying with agency policies/procedures and national safety goals and identifying & communicating workarounds that have a potential impact on patient safety. Demonstrates knowledge and skills in location, operation, care and troubleshooting of agency equipment independently.
  • Clinical Assessments - Performs and documents comprehensive and holistic assessments. Interprets and responds to abnormal diagnostic data. Anticipates potential emergency situations and intervenes safely with assistance if needed.
  • Caring & Code of Conduct - Develops a relationship with the patient/family that facilitates mutual involvement in the planning of care. Treats patients with courtesy and respect. Seeks resources for reconciling one's own personal issues and biases.
  • Critical Thinking - Demonstrates basic critical thinking skills.
  • Documentation - Documentation is concise, accurate, and complete reflecting adherence to agency, regulatory and legal requirements.
  • Population Specific Competency - Completes population-specific mandatory education competencies as defined by the agency specific scope of service. Identifies age, cultural, or other population specific patient needs based on assessment findings. Works collaboratively with patients and families of diverse backgrounds to develop plan of care. Is tolerant of differences posed by patients and families while cognizant of personal biases.
  • Evidenced Based Practice & Research - Practice is consistent with Northern Light Health policy and procedures. Understands evidence for practice change. Demonstrates knowledge of reliable resources to support evidenced based practice.
  • Leadership and Professional Conduct - Utilizes appropriate time management and meets the expectations for punctuality and attendance. Demonstrates flexibility in scheduling to support the staffing needs of patient care areas. Contributes to a healthy work environment by consistently utilizing effective communications with all members of the interdisciplinary team. Ensures continuity of care by reporting and addressing actual or potential conflict.
  • Collaboration and Teamwork - Actively implements and updates multidisciplinary plan of care and collaborates with internal and external resources to meet patient care needs. Identifies and evaluates changes in patient conditions that impact staffing, frequency of visits or the provision of safe patient care. Contributes to a healthy work environment by consistently exhibiting professional behaviors and addressing interpersonal conflicts with the right person, at the right time, in the right location. Support colleagues in the daily care of patients in the department. Collaborates with the interdisciplinary team to maximize patient care.
  • Resource Management - Identifies opportunities to improve utilization of resources.
  • Professional Development - Takes responsibility for meeting education and mandatory programs, by completing clinical evidence-based competencies (CBO) and department specific competencies. Seeks opportunities to promote and advance professional growth. Serves on and/or contributes to the work of local or agency-based practice committee. Seeks evidence in nursing literature to identify/support best practice. Maintains an up-to-date personal educational file to demonstrate compliance with educational requirements. Actively participates in the peer review process.
  • Performance Improvement - Demonstrates knowledge of and contributes positively to department performance improvement outcomes. Identifies potential safety issues to department manager and/or local or agency-based practice committee.
  • Productivity - Provides service and produces work at or above expected levels of quality and consistent with agency defined quantitative standards.
  • Other Duties.

Other Information:
  • Valid driver's license with reliable transportation and agency required auto liability insurance. Must be able to drive within assigned region as directed.
  • BLS for Healthcare Providers is required to be obtained prior to independent visits.

Competencies and Skills
  • Achieves Results: Sets high standards for their own outcomes and seizes opportunities to engage others towards objectives. Consistently moves forward with direct actions in order to attain or exceed objectives. Manages their own time effectively to accomplish assigned tasks. Successfully prioritizes multiple projects and duties as needed.
  • Arithmetic
  • Basic Life Support
  • Catheterization
  • Demonstrates Adaptability: Learns quickly when facing a new problem or unfamiliar task; is flexible in their approach with changing priorities and ambiguity. Manages change effectively and does not give up during adversity. Capable of changing one's behavioral style and/or views in order to attain a goal. Absorbs new information readily and puts it into practice effectively.
  • Demonstrates Emotional Intelligence: Exhibits a high level of self-awareness, self-management, other awareness and relationship management. Conducts themselves in an empathic, appropriate way, with a sense of humor and stimulates a collaborative work environment. Is respectful of the attitudes, feelings, or circumstances of others and aware of the influence of their own behavior on them. Is aware of relevant social, political, system, and professional trends and developments and uses this information for the organization's benefit.
  • Effectively Communicates: Listens, speaks and writes appropriately, using clear language. Communication methods are fitting to the message(s), audience, and situation and follow-ups are regular and timely. Shows that important (non-) verbal information is absorbed and understood and asks further questions to clarify when necessary. Expresses ideas and views clearly to others and has ability to adjust use of language to the audiences' level.
  • Exercises Sound Judgment & Decision Making: Understands and processes complex information, which allows for appropriate and accountable conclusions. Does not react too quickly or slowly. Balances facts, goals, and potential approaches taking the appropriate criteria into account. Makes active decisions and commits oneself by communicating confidently and respectfully.
  • Human Capital, Supply Chain and Financial Software.
  • Injection Administartion
  • IV Placement
  • Ability to understand the language used to precisely describe the human body including its components, processes, conditions affecting it, and procedures performed upon it.
  • Email application with the ability to manage email as well as calendars, managing tasks and contacts, note taking, journaling, and web browsing.
  • MS Teams
  • Multi-line phone, scanner, photocopier, fax, and internet.
  • Obtain Vital Signs
  • Promotes Health and Safety: Promotes a healthy and safe environment for patients, employees and visitors. Advocates and models healthy physical and mental health behaviors even in challenging circumstances. Sets high quality standards and strives for continuous improvement and quality assurance by reporting and encouraging others to report near misses and safety issues.
  • Provides Patient-Centered Care: Demonstrates understanding of patient care quality and service as organizational priority. Proactively supports change to improve patient experience and results. Exhibits the ability and willingness to find out what the patient wants and needs and to act accordingly, taking the organizational and outside resources into account. Cooperates, collaborates, communicates, and integrates care within and between teams to ensure that care is continuous and reliable.
  • Resolves Conflict: Promptly acts to find alternatives/solutions when team members disagree. Addresses issues in a direct, honest, and appropriate manner. Handles conflicting interests diplomatically and helps to solve them. Transforms difficult situations into teachable moments using respect and accountability .
  • Specimen Collection
  • Sterile Gloving Technique
  • Utilizes Resources Effectively: Understands how to get the most out of available resources and uses cost-benefit thinking in decision-making and in setting priorities. Monitors and analyzes resource usage to identify and eliminate areas of waste and maximize resources. As a leader, defines targets and provides appropriate means; oversees progress and makes adjustments when necessary. Appropriately delegates work, sets clear direction and manages workflow and time.
  • Wound Care
  • Zoom
  • Behaves with Integrity and Builds Trust: Acts consistently in line with the core values, commitments and rules of conduct. Leads by example and tells the truth. Does what they say they will, when and how they say they will, or communicates an alternate plan.
  • Cultivates Respect: Treats others fairly, embraces and values differences, and contributes to a culture of belonging, empowerment, and cooperation.
  • Fosters Accountability: Creates and participates in a work environment where people hold themselves and others accountable for processes, results and behaviors. Takes appropriate ownership not only of successes but also mistakes and works to correct them in a timely manner. Demonstrates understanding that we all work as a team and the quality and timeliness of work impacts everyone involved.
  • Practices Compassion: Exhibits genuine care for people and is available and ready to help; displays a deep awareness of and strong willingness to relieve the suffering of others.

Credentials
  • Required Registered Nurse
  • Required Driver's License

Education
  • Required Associate's DegreeBachelor's Degree Preferred.

Required Experience
  • 1 year/years of Clinical Experience

Working Conditions
  • Lifting, moving and loading 30 to 50 pounds.
  • Alternate shift schedules (day, evening, nights, weekends).
  • Potential exposure to abusive and/or aggressive people.
  • Potential exposure to hazardous materials.
  • Potential exposure to noxious odors.
  • Potential exposure to very hot or cold temperatures.
  • Prolonged periods of sitting.
  • Prolonged periods of standing.
  • Prolonged periods of walking.
  • Potential exposure to diseases or infections.
  • Work with computers, typing, reading or writing.
  • Work beyond the regularly scheduled hours.
  • Extend body and limbs to reach items.
  • Prolonged periods of kneeling.
  • Need to travel to perform responsible duties

Questions? Contact Talent Acquisition:
phone: 207-973-7100
email: talentacquisition@northernlight.org
Maine, Aroostook County, Bangor, Waterville, Ellsworth, Presque Isle, South Portland, Home Care, Hospice Care, end of life, respite care, Home Health Aide, Skilled Nursing

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