Clinical Reviewer, Inpatient Rn

Point32health Inc

Base: $94,136.62 - $141,204.92 annually; bonus/equ...
Fully remote
Licensed massachusetts rn required
3 years clinical nursing experience
3 years utilization management experience
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.
  • Candidates must possess current unrestricted Massachusetts RN licensure along with at least three years of both clinical nursing and utilization management experience.

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: Comprehensive total rewards including medical, dental, vision, retirement, and tuition programs

Skills & Requirements

Must-have

  • Licensed Massachusetts RN required
  • 3 years clinical nursing experience
  • 3 years utilization management experience
  • Evidence-based criteria application
  • Medical necessity determination skills
  • Inpatient acute care review

Nice-to-have

  • Strong negotiation and communication skills
  • Mentoring new staff capabilities
  • Collaborative team environment fit
  • Flexibility for special projects
  • Self-directed time management

Key Requirements

  • Current unrestricted Massachusetts RN license
  • Minimum 3 years clinical nursing experience
  • Minimum 3 years utilization management experience
  • Associate degree minimum; BSN preferred

Work Rights

Must have Massachusetts RN license

Tailored Resume

Cover Letter