Registered Nurse (RN) Utilization Review in Medford, MA

We are seeking a Utilization Review nurse for our client company a celebrated insurance provided just north of Boston. This is a contract opportunity that can turn to a perm position if both you and the company feel the fit. As review nurse you will ensure that the member population receive timely concurrent review / interventions as established by the Medical Management department, assures efficient operation for the membership with ongoing and continuous improvement in process and outcome. Responsible for concurrent review processes / interventions and the reviews of acute/post acute facility LOS and coordinate discharge plans for alternate levels of care and available community resources. Hands-off to case management or disease/program (specific diagnoses) to appropriate case manager for program admission as appropriate. This position will work directly with the Manager/Clinical Lead of Medical Management to assure appropriate LOS, medical necessity and level of care for the membership population. If you or someone you know is interested in this opportunity kindly call Nicole Monday ? Friday at [removed phone] or email your resume to Nicole Noftle for immediate consideration.
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