- US Tech Solutions (Canton, MA)
- …This is Fully remote, but Massachusetts RN license required.** **Job Summary The Clinical Reviewer is a licensed professional -a Registered Nurse preferred- that ... clinically complex caseload of varied requests for services. The Clinical Reviewer is responsible for making the... functions as a member of the Precert / Outpatient UM team and works under the… more
- Fallon Health (Worcester, MA)
- …authorization process + On-site, off-site and telephonic inpatient case management rounds + Outpatient case management rounds + Provider appeals review + Member ... nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences,...director on-call coverage + Support the benefits and technology review process + Provide support for UM … more