Massachusetts Licensed Inpatient Review Nurse

Job Summary

A company is looking for a UM Inpatient Clinical Review Nurse.

Key Responsibilities

• Perform pre-service, concurrent, and retrospective reviews to determine appropriate care and setting
• Document and maintain review findings in health management systems according to policies and guidelines
• Collaborate with healthcare providers and Medical Directors to approve medical determinations or provide recommendations

Required Qualifications

• Current MA RN License
• Bachelor's degree
• 3-5 years of nursing experience
• Knowledge of utilization management, Medicare, and Medicaid preferred
• Computer literacy and ability to navigate through computer systems