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 seasoned Registered Nurse (RN) with a passion for Utilization Management (UM)? We have an exciting opportunity for you to embark on a transformative 12-week travel healthcare assignment in picturesque Falmouth, Maine.
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 the efficiency of healthcare services. Your expertise in UM will be instrumental in improving patient outcomes and streamlining healthcare delivery processes.
Join us in Falmouth, Maine, where the charm of New England meets the beauty of coastal living. Explore historic sites, indulge in fresh seafood, and immerse yourself in the vibrant local culture while making a meaningful impact as a travel nurse in a dynamic healthcare setting.
At TLC Nursing, we understand the unique needs of healthcare professionals. As a nurse-founded agency, we provide round-the-clock recruiter support, personalized career guidance, assistance with housing arrangements, and support with licensing requirements. Your well-being and success are our top priorities.
**Weekly Pay: $2,193.66**
**Guaranteed Hours: 40.0 hours**
In addition to competitive pay, this travel assignment offers a comprehensive benefits package, including:
- 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
If you are ready to elevate your career as a travel nurse specializing in Utilization Management (UM) in the vibrant community of Falmouth, Maine, apply now and take the next step towards a rewarding and fulfilling healthcare assignment. Your journey starts here.