Massachusetts Licensed Clinical Care Reviewer

Job Summary

A company is looking for a Remote Registered Nurse (RN) Clinical Care Reviewer in Massachusetts.

Key Responsibilities

• Process medical necessity reviews for healthcare services and assist with discharge planning activities
• Coordinate care and engage with collaborative care partners to facilitate transitions to appropriate levels of care
• Provide guidance to clinical and non-clinical staff and attend medical advisement meetings as needed

Required Qualifications, Training, and Education

• Associate of Science (A.S) from an accredited registered nursing (RN) degree program
• Three (3) years of clinical experience required
• Preferred experience in med/surgical, emergency acute clinical care, or home health
• Current, unrestricted Registered Nurse (RN) Licensure in state(s) of practice required
• MCG Certification or ability to obtain within six (6) months of hire