Massachusetts Licensed Inpatient UM Clinician

Job Summary

A company is looking for an Inpatient UM Clinician.

Key Responsibilities

• Conduct concurrent and retrospective reviews of inpatient cases to assess medical necessity
• Monitor inpatient stays and collaborate with providers for efficient discharge planning
• Document review outcomes and ensure compliance with regulatory standards

Required Qualifications

• Active, unrestricted RN license in state of residence required
• 2+ years of utilization management or review experience using evidence-based criteria
• Experience in managed care environments preferred
• Background in inpatient care coordination or discharge planning strongly preferred
• Proficiency with EMR systems and Microsoft Office tools