Nurse Rev II-Greater Boston/Northeast (Home based with client visits)

University of Massachusetts Medical School; Shrewsbury; On-site; USD 70,000 - 90,000; Full time

Job summary

The University of Massachusetts Medical School is seeking a Nurse Reviewer II responsible for assessing clinical eligibility for individuals in nursing facilities or rehabilitation hospitals. This full-time position involves in-depth assessments and collaboration with healthcare providers to ensure safe service delivery, requiring a Bachelor’s in Nursing and relevant clinical experience.

Qualifications

• Registered Nurse (RN) with current Massachusetts licenses.
• 5-7 years of related work experience.
• Knowledge of applicable state regulations.

Responsibilities

• Conduct in-person assessments to evaluate clinical eligibility.
• Document clinical reviews and maintain applicant records.
• Collaborate with multi-disciplinary teams to assess needs.

Skills

Critical thinking

Communication

Teamwork

Education

Bachelor’s Degree in Nursing

Tools

Office Applications

Database Systems

Job description

Explore the Possibilitiesand Advance with Us.

You can view all open jobs by clicking here or use the following search form to find jobs that suit your specificcareer interests.

Nurse Rev II-Greater Boston/Northeast (Home based with client visits) Job Number: 2025-48446
Category: Nursing
Location: Shrewsbury, MA
Shift: Day
Exempt/Non-Exempt: Exempt
Business Unit: ForHealth Consulting
Department: ForHealth Consulting - Community Service - W401950
Job Type: Full-Time
Salary Grade: 45
Num. Openings: 1
Post Date: July 17, 2025

Job Summary

Under the general supervision of the Associate Director, or designee, the Nurse Reviewer II is responsible for completing in-person assessments and reviewing medical records to determine clinical eligibility for individuals who are residing in a nursing facility, chronic disease, or rehabilitation hospital who would like to return to the community and receive supports and services through the ABI and MFP Home and Community Based Waivers. Additionally, the Nurse Reviewer II completes annual or interval in-person assessments by reviewing medical records, assessing community needs and risks, and provides resource support for program participants/applicants. This position ensures that eligible individuals can be safely served in accordance with relevant program/waiver guidelines and regulations.

Major Responsibilities

• Contribute as an active member of a multi/inter-disciplinary team to assess, plan, organize, review and evaluate clinical eligibility.
• Conduct on-site assessments of applicants/participants medical, functional, psychosocial, and supportive needs to determine community, whether risks can be mitigated, and mitigation strategies within the terms of the ABI/MFP Waiver.
• Review and document all relevant information into data system applications in accordance with program guidelines and regulations.
• Utilizes critical thinking skills to complete written, clinically based comprehensive assessments that accurately depict the applicants/participants holistic needs, without bias.
• Contact providers, state agency offices, and applicants/participants, and collateral support to obtain information and records needed to conduct a comprehensive clinical review of the case and final determination.
• Review and document all relevant information into data system applications in accordance with program guidelines and regulations.
• Maintain individual records documenting all applicant/participant encounters and contacts.
• Foster and promote continuity of care and cooperative partnerships by liaising with health care providers, acute care hospitals, long term care facilities and other programs/organizations involved in the provision of services.
• Participate in public relations efforts, attending conferences and meetings as needed.
• Maintain positive working relationships with applicants/participants, and relevant informal supports, provider organizations, program consultants and state agencies.
• Maintain the confidentiality of all business documents and correspondence per UMass Chan Medical School (UMass Chan)/ForHealth Consulting procedures and HIPAA regulations.
• Participate in performance improvement initiatives and demonstrate the use of quality improvement in daily operations.
• Comply with established departmental policies, procedures and objectives.
• Comply with all health, safety and program regulations and requirements.
• Participates in training and onboarding of new clinical staff
• State-wide travel is required for this position.
• Perform other duties as required.

Required Qualifications

• Bachelor ‘s Level Degree in Nursing
• RN with current licensure to practice in Massachusetts
• 5-7 years of related work experience
• Knowledge of applicable state regulations
• Ability to travel statewide
• Experience with Office Application and database

Preferred Qualifications

• Experience with disabled or long term care populations
• Experience in one of the following areas: Long-Term Care, Home Care, Rehab, Brain Injury, Mental Health, Substance Abuse and/or Disabilities.

Physical Theraptists encouraged to apply

UMass Chan Medical School was among 23 companies that stood out as 2023 “DEI champions,” according toThe Boston Globe.

Named a U.S. News & World Report
“2023 BEST MEDICAL GRAD SCHOOL”
for Primary Care and Research