Travel Registered Nurse Utilization Management Job, Falmouth, ME

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) with expertise in Utilization Management (UM)? Ready to embark on an exciting 12-week travel healthcare assignment in picturesque Falmouth, Maine? TLC Nursing is seeking a dedicated RN to join our dynamic team for this specialized opportunity. In this role, you will play a vital part in ensuring optimal utilization of healthcare resources, collaborating with interdisciplinary teams to assess, plan, implement, and evaluate patient care. Your expertise in UM will be crucial in promoting quality outcomes while managing costs effectively. Beyond the professional growth this assignment offers, you'll have the chance to explore the charming coastal town of Falmouth. From its quaint New England architecture to its vibrant local culture, Falmouth provides a perfect backdrop for your travel nurse experience. At TLC Nursing, we understand the value of work-life balance and support our nurses every step of the way. Our nurse-founded agency provides 24/7 recruiter support, personalized career guidance, and assistance with housing and licensing, ensuring a seamless and rewarding assignment for you. **Weekly Pay:** $2,193.66 **Guaranteed Hours:** 40.0 (if applicable) Join us and enjoy the following benefits: - Best in the Industry Pay Packages - $25,000 Life Insurance Policy – Effective from Day One - Medical, Dental, and Vision Insurance – available the 1st of the month after hire - Paid Time Off – Accrued Day 1, eligible after 1 year of employment (unless required earlier by state law) - 401(k) – Available after 1 year of employment; fully vested after 5 years - Aflac – Available for employee purchase - Referral Program – Payouts for referring other healthcare professionals - EAP – Free, confidential services for employees and their households via Invest EAP Ready to take the next step in your nursing career? Apply now and seize this exceptional opportunity to make a difference while exploring the beauty of Falmouth, Maine.