Inpatient RN - Clinical Utilization & Care Coordination

US Tech Solutions; United States; On-site; USD 80,000 - 100,000; Full time

Job summary

A global staff augmentation firm is seeking a Clinical Reviewer, Inpatient RN, to manage complex inpatient caseloads and determine medical necessity. Candidates must possess a current Massachusetts RN license and have at least three years of clinical nursing and utilization management experience. Excellent interpersonal skills and the ability to work independently are essential. This role involves balancing multiple demands in a fast-paced business environment with potential holiday/weekend rotation requirements.

Qualifications

• Minimum of three years of clinical nursing experience.
• Minimum of three years of UM experience, preferably in an inpatient setting or managed care.

Responsibilities

• Function independently managing complex inpatient caseloads.
• Determine medical necessity for benefit coverage.
• Manage utilization and discharge planning activities.

Skills

Interpersonal skills

Time management

Clinical judgment

Mentoring

Proficiency in Microsoft Word

Proficiency in Microsoft Excel

Education

Registered Nurse with current, unrestricted MA license

BSN preferred

Job description

A global staff augmentation firm is seeking a Clinical Reviewer, Inpatient RN, to manage complex inpatient caseloads and determine medical necessity. Candidates must possess a current Massachusetts RN license and have at least three years of clinical nursing and utilization management experience. Excellent interpersonal skills and the ability to work independently are essential. This role involves balancing multiple demands in a fast-paced business environment with potential holiday/weekend rotation requirements.