Clinical Reviewer, Inpatient RN
Tufts Health Plan
About this role
The Clinical Reviewer, Inpatient RN provides utilization management activities for members in an inpatient setting, determines medical necessity for coverage, and supports discharge planning. The role involves working with providers, applying clinical criteria, and ensuring cost-effective care.
Skills
Qualifications
About Tufts Health Plan
tuftshealthplan.comExplore all that Tufts Health Plan has to offer — from Medicare and Medicaid plans to Health Connector and employer-based plans. You’ll also find information on HMOs, PPOs and open enrollment periods, reasons why Tufts Health Plan has been a trusted health insurance provider for over 40 years, and so much more.
Recent company news
NBC BostonTufts, Harvard Pilgrim parent company cuts 100 jobs
1 week ago
The Boston GlobeHarvard Pilgrim and Tufts Health Plan parent company slashes more jobs amid rising costs
1 week ago
The Business JournalsPoint32Health narrows operating loss to $301M amid cost cuts, layoffs
2 weeks ago
NBC BostonState's second-largest health plan posts $301M operating loss
2 weeks ago
MassLive.comMassachusetts’ second largest health insurer lays off 250+ employees in another round of cuts
Oct 21, 2025
About Tufts Health Plan
Headquarters
San Francisco, CA
Company Size
201-500 employees
Founded
2018
Industry
Technology
Glassdoor Rating
4.2 / 5
Leadership Team
Sarah Johnson
Chief Executive Officer
Michael Chen
Chief Technology Officer
Emily Williams
VP of Engineering
David Rodriguez
VP of Product
Jessica Thompson
Chief Financial Officer
Andrew Park
VP of Sales
Unlock Company Insights
View leadership team, funding history,
and employee contacts for Tufts Health Plan.
Salary
$94k – $141k
per year
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