Job Description
Job Overview
TLC Nursing Associates, Inc. is seeking a skilled and detail-oriented Registered Nurse – Utilization Management (UM) to review healthcare services, ensure clinical appropriateness, and coordinate effective patient care within regulatory guidelines.
Responsibilities
- Review patient medical records, treatment plans, and diagnostic information to assess the necessity and appropriateness of care.
- Collaborate with healthcare providers, insurance companies, and case managers to facilitate approval of services.
- Ensure compliance with clinical guidelines, payer policies, and regulatory standards.
- Analyze utilization data and identify opportunities for care improvement and cost containment.
- Communicate utilization decisions and provide education to providers and patients regarding coverage and care options.
- Document all review activities accurately and maintain patient confidentiality.
- Support quality assurance initiatives related to utilization management processes.
Qualifications
- Current Registered Nurse (RN) license in the state of practice.
- Experience in utilization management, case management, or clinical review preferred.
- Strong clinical assessment, critical thinking, and decision-making skills.
- Knowledge of healthcare regulations, insurance processes, and clinical guidelines.
- Excellent communication, organizational, and interpersonal skills.
- Ability to work independently and as part of a multidisciplinary team.
Benefits
- Competitive pay and flexible contract options.
- Comprehensive medical, dental, and vision insurance plans.
- Opportunities for professional growth and continuing education.
- Supportive work environment with 24/7 access to a dedicated staffing and clinical liaison team.
Job Description
Are you a skilled Registered Nurse (RN) specializing in Utilization Management (UM) seeking a unique travel healthcare adventure? We have an exciting 9-week assignment waiting for you in the picturesque town of Camden, Maine.
As a travel nurse in this role, you will play a vital part in managing and optimizing healthcare resources, ensuring efficient and effective utilization of services for patients. Your responsibilities will include collaborating with healthcare teams, reviewing medical records, assessing patient needs, and implementing care plans to maximize quality outcomes.
At TLC Nursing, we pride ourselves on our nurse-founded organization that provides round-the-clock recruiter support, personalized career guidance, and assistance with housing and licensing. Join our team and experience the TLC difference firsthand.
In addition to the engaging work environment, you'll enjoy Best in the Industry Pay Packages, a $25,000 Life Insurance Policy effective from day one, and comprehensive benefits such as medical, dental, and vision insurance available from the 1st of the month after hire. Paid Time Off accrues from day one, with eligibility after 1 year of employment, and a 401(k) plan becomes available after 1 year, fully vested after 5 years. You can also benefit from Aflac options, referral program payouts, and Employee Assistance Program (EAP) services for you and your household.
Don't miss this opportunity to enhance your career while exploring the charms of Camden, Maine. Apply now and take the next step towards an enriching travel healthcare assignment with TLC Nursing.
Job Tags
Contract work, Flexible hours