Clinical Reviewer – Inpatient Registered Nurse

Job overview

The Clinical Reviewer – Inpatient Registered Nurse role is onsite in Canton, MA. Pay is $40–$60 per hour. The reviewer supports inpatient utilization management and discharge planning for members across assigned facilities. The role assesses medical necessity, level of care, and readiness to transition to a lower level of care, applying clinical criteria and health-plan policies. It works with providers and the inpatient team to support timely, clinically appropriate coverage decisions and care transitions.

What you'll do

• Manage a clinically complex inpatient caseload
• determine medical necessity and benefit coverage
• conduct utilization management and discharge planning
• apply clinical criteria to assess medical necessity, level of care, and transition readiness
• develop working relationships with providers
• document activities and escalate issues as appropriate
• may float to unassigned facilities for coverage.

What we're looking for

Skills & competencies

clinical reviewer

registered nurse

inpatient

utilization management

discharge planning

canton ma

onsite

$40–$60/hr

massachusetts rn license

clinical criteria

provider collaboration

holiday/weekend rotation may be required

Work arrangement

• Weekend coverage required

Why this role

Requires an active, unrestricted Massachusetts RN license, at least three years of clinical nursing experience, and at least three years of utilization management experience, preferably inpatient or managed care. Holiday/weekend rotation may be required; BSN preferred.

About the employer

US Tech Solutions, Inc. is hiring for this role. Industry: Employment Placement Agencies. Sector: 56.