Utilization Review Analyst - Registered Nurse (Per Diem)

Medical Care of Boston Management Corporation(2 months ago)

OnsitePart TimeSenior$76,220 - $196,460Case Management

About this role

The Utilization Analyst is a per-diem clinical role based on-site at Lahey Hospital and Medical Center that validates the medical necessity of inpatient care. The position analyzes medical documentation using utilization review, clinical documentation improvement, and revenue integrity principles to ensure appropriate reimbursement aligned with the intensity of care provided.

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Required Skills

Utilization Review
Clinical Documentation
Revenue Integrity
Case Management
Medical Documentation
Physician Communication
Payer Relations
Data Analysis
Reporting
Collaboration

+1 more

Qualifications

RN
Bachelor’s Degree
CDIP
CCM
ACM

About Medical Care of Boston Management Corporation

cms.gov

The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the U.S. Department of Health and Human Services (HHS) that administers the nation's major healthcare programs, including Medicare and Medicaid. CMS is responsible for overseeing the healthcare system in the United States, ensuring access to high-quality healthcare services and improving health outcomes for its beneficiaries. Through its initiatives and regulations, CMS aims to provide a more transparent healthcare system and reduce costs while enhancing care delivery across the nation.

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