Destava

RN Clinical Care Reviewer - Must have MA RN license Direct UM Experience Preferred!

CareSource Management Services is hiring for RN Clinical Care Reviewer - Must have MA RN license Direct UM Experience Preferred! in Massachusetts WFH. Remote, Mid level. First seen November 11, 2026; open as of November 13, 2026. Jobs taken straight from company career pages — no aggregator in between.

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Company
CareSource Management Services
Where
Massachusetts WFH
Arrangement
Remote
Level
Mid
First seen
November 11, 2026
Listed via
Workday

What the posting says

Job Summary: The Clinical Care Reviewer II - Massachusetts is responsible for processing medical necessity reviews for appropriateness of authorization for health care services, assisting with discharge planning activities (i.e. DME, home health services) and care coordination for members, as well as monitoring the delivery of healthcare services. Essential Functions: - Complete prospective, concurrent and retrospective review such as acute inpatient admissions, post-acute admissions, elective inpatient admissions, outpatient procedures, homecare services and durable medical equipment. -…

Read more and apply on CareSource Management Services' site

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