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Utilization Review Jobs in Maine (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

Pharmacy Careers

Remote Clinical Review Pharmacist

Lewiston, ME · On-site

$125K - $149K/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

Humana

Compliance UM Nurse (Wed - Sun)

Augusta, ME · On-site

Become a part of our caring community The Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent ...

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.

York Hospital

RN - Other

York, ME · On-site

Must have utilization review and discharge planning experience. * Certification by a nationally recognized case management or utilization review organization preferred. * Must have active BLS. CCM or ...

York Hospital

RN Care Manager

York, ME · On-site

Certification by a nationally recognized case management or utilization review organization preferred or obtained within 18 months of hire. YORK HOSPITAL IS AN EQUAL OPPORTUNITY EMPLOYER.

Generis Tek Inc

RN Care Manager

York, ME · On-site

Certification by a nationally recognized case management or utilization review organization preferred. * Must have active BLS. CCM or ACM preferred. Minimum Guaranteed Hours: 3

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All JobsUtilization Review JobsUtilization Review Jobs in Maine

Utilization Review information

See Maine salary details

$20

$40

$66

How much do utilization review jobs pay per hour?

As of Aug 11, 2026, the average hourly pay for utilization review 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.

Is utilization review work from home?

Utilization review jobs can often be performed remotely, especially with the increased adoption of telecommuting in healthcare and insurance industries. Many employers offer work-from-home options, provided the reviewer has the necessary certifications and access to electronic health records or claims systems. However, some positions may require on-site presence for meetings or audits.

What does a utilization review do?

A typical day in Utilization Review involves reviewing patient medical records, evaluating the necessity and appropriateness of proposed treatments or services, and documenting recommendations based on clinical criteria and insurance policies. Utilization Review specialists often collaborate closely with physicians, nurses, and insurance representatives to gather additional information and clarify cases. While much of the role is desk-based and may include remote work options, it requires regular communication with both clinical and administrative teams. This position offers variety and challenge, as no two cases are exactly alike, and there are often opportunities to advance into supervisory or quality improvement roles within the department.

Is utilization review a stressful job?

Utilization review is a healthcare role that involves evaluating medical necessity and appropriateness of services, which can be stressful due to strict deadlines, high accuracy requirements, and the need to balance patient care with insurance policies. The job often requires strong attention to detail, communication skills, and the ability to handle complex cases under time pressure.

What is a utilization review?

A Utilization Review (UR) job involves assessing the medical necessity, efficiency, and appropriateness of healthcare services. UR professionals, often nurses or healthcare specialists, review patient records, insurance claims, and treatment plans to ensure they meet industry standards and payer requirements. They work with healthcare providers, insurance companies, and regulatory agencies to optimize care while controlling costs. Their goal is to balance quality patient care with cost-effective resource utilization.

What are the key skills and qualifications needed to thrive in utilization review?

To thrive in Utilization Review, professionals typically need a background in nursing or healthcare, strong clinical assessment capabilities, and a thorough understanding of medical guidelines and insurance regulations. Familiarity with electronic medical records (EMR) systems and utilization management software, and often certification such as Certified Utilization Review Specialist (CURN), are important. Excellent critical thinking, attention to detail, and strong communication skills enable effective case evaluation and collaboration with healthcare teams. These skills and qualifications ensure objective, accurate decisions that support cost-effective, quality patient care within compliance standards.

How do I get into a utilization review?

To become a utilization review specialist, typically a healthcare or related degree such as nursing, health administration, or social work is required. Certification in case management or utilization review, such as the Certified Professional in Healthcare Quality (CPHQ), can enhance job prospects. Relevant skills include knowledge of medical coding, insurance policies, and strong analytical abilities.
What are the most commonly searched types of Utilization Review jobs in Maine? The most popular types of Utilization Review jobs in Maine are:
What are popular job titles related to Utilization Review jobs in Maine? For Utilization Review jobs in Maine, the most frequently searched job titles are:
What job categories do people searching Utilization Review jobs in Maine look for? The top searched job categories for Utilization Review jobs in Maine are:
What cities in Maine are hiring for Utilization Review jobs? Cities in Maine with the most Utilization Review job openings:
Utilization Review jobs near you
Infographic showing various Utilization Review job openings in Maine as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 14% Part Time, and 3% Contract. 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.

RN - Utilization Review

Genesis WINDWARD GARDENS

Camden, ME • On-site

$18/hr

Other

Posted 8 days ago

Job description

Travel Offering Nursing Profession

Nursing Profession RN Specialty Utilization Review Regular Pay Rate $18 Shift Details Shift 12 hour days Job Order Details Start Date 08/01/2026 End Date 09/03/2026 Duration 5 Week(s) Client Details City Camden State ME

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