- Reviews admissions and service requests within assigned unit for prospective, concurrent, and retrospective medical necessity and/or compliance with reimbursement policy criteria.
- Collaborates to assess and coordinate patient's discharge planning needs with members of the healthcare team
- Assists multidisciplinary teams with issues related to medical records/documentation, pre-certifications, reimbursement and claim denials/appeals.
- Monitors for delays in care and prepares data to reduce length of stay and maximize reimbursement.
- State of Maine licensure as a Registered Nurse (RN) or ability to obtain in a timely fashion, required
- Utilization Review or Care Management experience, is strongly preferred.
- We offer quality health, dental, and vision benefits and wellness programs and resources to provide employees access to resources for a healthy lifestyle and help manage health care costs.
- Employees have access to industry-leading leave for new parents.
- A generous earned time plan is offered to all employees - We believe employees need and deserve time away from work to observe holidays, be with family, go on vacation, or simply take care of themselves.
- An employee discount program is available to all employees for services provided by MaineGeneral Medical Center.
- Loan Reimbursement is available for this position dependent upon current degree level. Please discuss benefit with the recruiter.
- Tuition Reimbursement is available to all employees to further develop skills and career.
- We offer eligible employees up to 2% of eligible pay in 403(b) company-matching contributions plus another 2% in the 401(a) retirement income plan.
- Three insurance plans are available to protect your family from the sudden loss of income in the event of your death, terminal illness or serious injury from accident.
- We offer both short-term and long-term disability insurance to replace a portion of your income if you become disabled and cannot work for a period of time.
Helping our employees develop their skills and grow their careers is critical to how we retain our talent and sustain our business. We do this by offering our teammates a variety of leadership-supported programs and learning and development resources for every stage of their professional development. We know that our employees are our most valuable resource they are how we grow our business and care for our community.