Point32Health is a leading not-for-profit organization dedicated to delivering high-quality, affordable healthcare to nearly 2 million members
Job Summary
Point32Health is a leading not-for-profit organization dedicated to delivering high-quality, affordable healthcare to nearly 2 million members.
The Clinical Reviewer, Inpatient RN is responsible for determining medical necessity and benefit coverage for complex inpatient cases across multiple lines of business.
Employees are eligible for a comprehensive total rewards package including medical, dental, vision, retirement plans, and tuition programs.
Matching Summary
Point32Health is a leading not-for-profit organization dedicated to delivering high-quality, affordable healthcare to nearly 2 million members.
Salary
Base: $94,136.62 - $141,204.92 annually; Bonus/Equity: Variable pay eligibility mentioned; Benefits: Medical, dental, vision, retirement, PTO, life insurance included
Skills & Requirements
Must-have
Current unrestricted Massachusetts RN license
3 years clinical nursing experience
3 years utilization management experience
Evidence-based criteria application
InterQual or MNGs proficiency
Nice-to-have
Strong negotiation and communication skills
Ability to mentor new staff
Experience with DRG reimbursement models
Collaborative team environment adaptability
Key Requirements
Registered nurse with current Massachusetts RN license