Job Title: Registered Nurse – Utilization Management (RN UM)
Location: Camden, ME 04843
Position Type: Contract
Assignment Duration: 14 Weeks
Schedule: Monday – Friday | 8:00 AM – 4:30 PM
Travel Rate: $50 – $56 per hour (based on experience)
We are seeking an experienced Registered Nurse (RN) with Utilization Management expertise for a 14-week contract assignment in Camden, ME. The RN UM will be responsible for reviewing admissions, ensuring medical necessity, coordinating payer communications, and maintaining compliance with CMS and state regulations within a skilled nursing or post-acute care setting.
Review patient admissions to determine medical necessity and appropriate level of care.
Verify insurance coverage and obtain required prior authorizations.
Communicate with insurance providers regarding approvals, denials, and appeals.
Monitor resident length of stay and evaluate ongoing skilled coverage eligibility.
Coordinate Medicare, Medicaid, and managed care documentation requirements.
Conduct concurrent reviews to support continued stay justification.
Track skilled nursing days and benefit periods accurately.
Prepare and submit required clinical documentation to payers.
Ensure compliance with CMS guidelines and state regulatory standards.
Active Registered Nurse (RN) license.
Current BLS (Basic Life Support) certification.
Experience in Utilization Management, Case Management, or Skilled Nursing review processes preferred.
Strong knowledge of Medicare, Medicaid, and managed care regulations.
For more details reach at Aditi.sharma@navitashealth.com or Call / Text at 516-587-6677.
About Navitas Healthcare, LLC: It is a certified WBENC and one of the fastest-growing healthcare staffing firms in the US providing Medical, Clinical and Non-Clinical services to numerous hospitals. We offer the most competitive pay for every position we cater. We understand this is a partnership. You will not be blindsided and your salary will be discussed upfront.