Job Title: Registered Nurse – Utilization Management (RN UM)
Location: Orono, ME 04473
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 currently seeking a qualified Registered Nurse (RN) with Utilization Management experience for a 14-week contract assignment in Orono, ME. The RN UM will be responsible for ensuring medical necessity, appropriate level of care, and regulatory compliance within a skilled nursing or post-acute care setting. The ideal candidate will have strong knowledge of Medicare, Medicaid, and managed care guidelines.
Review new and ongoing admissions for 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 continued skilled coverage eligibility.
Coordinate Medicare, Medicaid, and managed care documentation requirements.
Conduct concurrent reviews to support continued stay authorization.
Track skilled nursing days and manage benefit periods accurately.
Prepare and submit required clinical documentation to payers in a timely manner.
Ensure compliance with CMS regulations and state guidelines.
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.