UTILIZATION REVIEW CASE MANAGER - Per Diem

The starting rate for this position is: $32.48

Rate of pay displayed reflects the beginning of the pay scale.  At the time of an offer, determination of your offer will reflect your skills and experience as it relates to the position.

Summary
 
In direct delivery of patient care, and under the supervision of the VP of Accountable Care Operations & Population Health Strategy the Utilization Review Case Manager will work collaboratively with other members of the healthcare team. The nurse case manager also acts as an advocate for the patient and assists in providing information regarding their insurance coverage. The UR Nurse Case Manager conducts medical necessity reviews in accordance with the Utilization Management (UM) plan for patients that are housed on a nursing unit, to include inpatient admissions, patients receiving observation services and outpatients in a bed. Identifies delays in care. Documents and communicates findings with the care team and the payor, when necessary.
 
Requirements
Education- 2 year College (Associates Degree) required
Years of Experience - 3-5 years required
Licenses - Active valid State of Maine RN License
Covenant Health Mission Statement

We are a Catholic health ministry, providing healing and care for the whole person, in service to all in our communities.

Our Core Values:

•Compassion

We show respect, caring and sensitivity towards all, honoring the dignity of each person, especially the poor, vulnerable and suffering.

•Integrity

We promote justice and ethical behavior, and responsibly steward our human, financial and environmental resources.

•Collaboration

We work in partnership, dialogue and shared purpose to create healthy communities.

•Excellence

We deliver all services with the highest level of quality, while seeking creative innovation.

Applicants, employees and former employees are protected from employment discrimination based on race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age (40 or older), disability, and genetic information (including family medical history).