- Cognizant (Augusta, ME)
- …you need to have to be considered** + Educational background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
- Northern Light Health (Waterville, ME)
- …Time Hours Per Week: 40.00 Work Schedule: 11:00 AM to 7:30 PM Summary: The Registered Nurse II is a fully competent practitioner of nursing. The incumbent is ... Practice Act, Northern Light Health Standards of Care/Practice, policies and procedures. The Registered Nurse II is responsible for the delivery of patient care… more
- Northern Light Health (Pittsfield, ME)
- …Valley Hospital Work Type: Part Time Eligible Hours Per Week: 20.00 Summary: The Registered Nurse II is a fully competent practitioner of nursing. The incumbent ... Practice Act Northern Light Health Standards of Care/Practice, policies and procedures. The Registered Nurse II is responsible for the delivery of patient care… more
- CVS Health (Augusta, ME)
- …conditions. + **Diabetes education experience** is required. + Current, unrestricted ** Registered Nurse (RN) license** ; multi-state licensure preferred. + ... health outcomes by engaging telephonically with individuals living with diabetes. This nurse will guide members through actionable steps to close gaps in care,… more
- Evolent (Augusta, ME)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals.… more
- CVS Health (Augusta, ME)
- …performance. **Education** Bachelor's degree preferred/specialized training/relevant professional qualification. Registered Nurse (RN) required. **Prior Relevant ... utilization reviews and assessments, applying evidence-based criteria and clinical knowledge to evaluate the medical necessity and appropriateness of requested… more
- Highmark Health (Augusta, ME)
- …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more