Permanent Utilization Review Registered Nurse

Join our team as a Utilization Review Registered Nurse in Attleboro, MA. In this permanent role, you will apply your expertise in utilization management to determine appropriate admission statuses based on regulatory and reimbursement requirements from commercial and government payers. You will perform concurrent and retrospective reviews, track outcomes, and collaborate with multidisciplinary staff to support process improvement.

This position offers an average pay of $58 per hour. You will work in a fast-paced environment, managing a diverse workload while maintaining current knowledge of payer regulations. Key responsibilities include conducting short stay reviews, facilitating InterQual updates, and providing training to staff.

Requirements include a BSN, current Massachusetts RN license, and 3-5 years of acute care case management experience with utilization review skills. Preferred qualifications include CCM or ACMA certification, experience with Cerner, and denials management. If you have strong analytical and communication skills, we invite you to apply and contribute to our Utilization Management program.