Inpatient UM Clinician (Remote) in Boston, Massachusetts - #73188 | VanderHouwen

Description

Job Id: 73188

Inpatient UM Clinician (Remote)
Our client is seeking an experienced Inpatient UM Clinician who combines strong clinical judgment with excellent organization, communication, and critical-thinking skills. The ideal candidate is comfortable independently managing a fast-paced inpatient caseload, collaborating across clinical teams, and making timely, evidence-based decisions while maintaining a strong focus on quality, compliance, and positive patient outcomes.

This role is fully remote with possible occasional travel to Boston, Massachusetts. Working Schedule will include working rotating Saturdays.

Inpatient UM Clinician Responsibilities

• Perform concurrent and retrospective utilization reviews of inpatient services using evidence-based criteria, clinical information, and applicable medical policies.
• Evaluate medical necessity and appropriate levels of care, escalating complex or non-qualifying cases to physician reviewers within required timelines.
• Monitor inpatient stays, identify barriers or delays in care, and collaborate with clinical and discharge planning teams to support appropriate transitions of care.
• Maintain thorough and timely case documentation, authorizations, communications, notifications, and other utilization management activities in accordance with regulatory and contractual requirements.
• Partner with medical directors, care management, providers, and internal teams to resolve complex cases, identify improvement opportunities, and support effective utilization management processes.

Inpatient UM Clinician Qualifications

• Active, unrestricted RN license in the state of residence; compact licensure or licensure in Massachusetts or New Hampshire is preferred.
• 2+ years of utilization review experience, including experience applying evidence-based criteria such as InterQual.
• Managed care experience with knowledge of inpatient review processes and discharge planning; Medicare and Medicaid experience is preferred.
• Nursing degree or diploma required; Bachelor of Science in Nursing or another bachelor’s degree is preferred.
• Strong clinical judgment, critical thinking, communication, documentation, organization, and time-management skills.
• Ability to work independently in a remote environment and participate in rotating Saturday and other after-hours coverage as required.

Compensation: $45-$50/hr. (DOE)

VanderHouwen Contractors Enjoy Exceptional Benefit Perks!
As an eligible contract employee with VanderHouwen, you’ll have access to a full suite of benefits designed with your well-being in mind. Our comprehensive package includes medical, dental, vision, life insurance, short- and long-term disability, and a matching 401(k) to help secure your future.

Meet VanderHouwen
What kind of recruiter do you see yourself working with? One who prioritizes your best interest, no matter what? VanderHouwen does, and we’re in it for the long game! Our recruiters focus on YOU, building meaningful, long-term relationships while developing a deep understanding of companies’ staffing needs and workplace cultures. This approach helps us find an ideal job match that aligns with your unique career aspirations and goals.

VanderHouwen is an award-winning, Women & Diversity-Owned, WBENC certified professional staffing firm. Founded in 1987, VanderHouwen places experienced professionals across the nation! Our recruitment teams specialize in either Technology and IT, Engineering, Human Resources, or Accounting and Finance career markets. Partner with us to land your next exciting career!

VanderHouwen is an Equal Opportunity Employer and participates in E-Verify. VanderHouwen does not discriminate based on race, color, religion, sex, national origin, age, disability, or any other characteristic protected by applicable local, state, or federal civil rights laws.

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