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Remote Outpatient Utilization RN | Medical Necessity Expert

Remote / Online - Candidates ideally in
Springfield, Hampden County, Massachusetts, 01119, USA
Listing for: IntelliResume
Remote/Work from Home position
Listed on 2026-09-25
Job specializations:
  • Nursing
    RN Nurse, Healthcare Nursing, Clinical Nurse Specialist
Salary/Wage Range or Industry Benchmark: 90000 - 134000 USD Yearly USD 90000.00 134000.00 YEAR
Job Description & How to Apply Below

Point
32

Health is seeking an Outpatient Clinician RN Reviewer to manage a clinically complex caseload and determine medical necessity for members. This remote MA role requires an RN license and five years in utilization management or related fields, with BSN preferred.

The position emphasizes independent work within a team, partnering with Medical Directors, and adherence to established processes to ensure timely coverage decisions.

Step into the Remote Outpatient Utilization RN | Medical Necessity Expert role at Intelli Resume in MA, United States and grow with us.

Please review the full job details above before applying.

If your experience matches this role, we encourage you to apply.

All applications are reviewed carefully by our team.

The position is based in MA, United States.

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