Nurse Reviewer II-Case Mgt
4 weeks ago
Nurse Reviewer II-Case Mgt (Home Based with Client Visits) Minimum Salary US-MA-Westborough Job Location 1 week ago(11/13/2025 4:26 PM) Requisition Number 2025-48959 # of Openings 1 Posted Date Day Shift Exempt Overview POSITION SUMMARY: ForHealth Consulting at UMass Chan Medical School is seeking a detail-oriented Nurse Reviewer II with experience caring for individuals with complex medical needs to join our Community Case Management Program. In this role, you will manage a caseload of members, ensuring they receive the long-term services and supports (LTSS) they need to thrive in the community. This position combines the flexibility of remote work with meaningful field interactions through home and site visits. You'll play a key role on a multidisciplinary team - assessing, planning, coordinating, and authorizing care for individuals with complex medical needs, while collaborating closely with providers, state agencies, and other healthcare partners to ensure continuity and quality of care. Responsibilities ESSENTIAL FUNCTIONS Serve as the clinical case manager for an assigned caseload of members.Conduct on-site assessments to determine medical necessity and clinical eligibility for Community Case Management and Continuous Skilled Nursing Services.Authorize, coordinate, and monitor long-term care services in accordance with program guidelines.Prepare and maintain comprehensive service records and documentation in compliance with program and HIPAA requirements.Collaborate with providers, hospitals, and agencies to foster integrated care delivery.Review service plans and modify as needed based on member progress or changing needs.Participate in performance improvement initiatives and support onboarding of new clinical staff. Qualifications REQUIRED QUALIFICATIONS:RN licensed to practice in Massachusetts5-7 years of work experience with at least 3 recent years providing direct service or case management to the pediatric, young adult, or adult medically complex populationAbility to travel statewide to Member homes and service providers places of businessExperience with Office Application and databaseValid Driver's license requiredPREFERRED QUALIFICATIONS:Experience with home careKnowledge of applicable state regulationsExperience with prior authorization and/or eligibility determinationsExperience with the care of medically complex individuals Additional Information Why Join Us At ForHealth Consulting, part of UMass Chan Medical School, we are dedicated to advancing health and well-being across Massachusetts communities. You'll be part of a mission-driven organization that values collaboration, innovation, and compassion in care management. #LI-VG1
-
Nurse Reviewer II-Case Mgt
1 week ago
Westborough, United States UMass Med School Full timeNurse Reviewer II-Case Mgt (Home Based with Client Visits) Location: UMass Chan Medical School Westborough, Massachusetts. Overview POSITION SUMMARY: ForHealth Consulting at UMass Chan Medical School is seeking a detail-oriented Nurse Reviewer II with experience caring for individuals with complex medical needs to join our Community Case Management Program....
-
Nurse Reviewer II-Case Mgt
3 days ago
Westborough, MA, United States UMass Med School Full timeNurse Reviewer II-Case Mgt (Home Based with Client Visits)Minimum Salary US-MA-WestboroughJob Location 2 days ago(12/4/2025 8:17 AM)Requisition Number 2025-48959# of Openings 1Posted Date DayShift ExemptOverviewPOSITION SUMMARY: ForHealth Consulting at UMass Chan Medical School is seeking a detail-oriented Nurse Reviewer II with experience caring for...
-
Nurse Reviewer II-Case Mgt
2 days ago
Westborough, MA, United States UMass Med School Full timeNurse Reviewer II-Case Mgt (Home Based with Client Visits)Minimum Salary US-MA-WestboroughJob Location 1 week ago(12/4/2025 8:17 AM)Requisition Number 2025-48959# of Openings 1Posted Date DayShift ExemptOverviewPOSITION SUMMARY: ForHealth Consulting at UMass Chan Medical School is seeking a detail-oriented Nurse Reviewer II with experience caring for...
-
Nurse Reviewer II-Case Mgt
5 days ago
Westborough, MA, United States UMass Med School Full timeNurse Reviewer II-Case Mgt (Home Based with Client Visits)Minimum Salary US-MA-WestboroughJob Location 2 days ago(12/4/2025 8:17 AM)Requisition Number 2025-48959# of Openings 1Posted Date DayShift ExemptOverviewPOSITION SUMMARY: ForHealth Consulting at UMass Chan Medical School is seeking a detail-oriented Nurse Reviewer II with experience caring for...
-
Nurse Reviewer II-Case Mgt
1 week ago
Westborough, MA, United States UMass Med School Full timeNurse Reviewer II-Case Mgt (Home Based with Client Visits)Minimum Salary US-MA-WestboroughJob Location 2 weeks ago(11/13/2025 4:26 PM)Requisition Number 2025-48959# of Openings 1Posted Date DayShift ExemptOverviewPOSITION SUMMARY: ForHealth Consulting at UMass Chan Medical School is seeking a detail-oriented Nurse Reviewer II with experience caring...
-
Nurse Reviewer II-Case Mgt
1 week ago
Westborough, MA, United States UMass Med School Full timeNurse Reviewer II-Case Mgt (Home Based with Client Visits)Minimum Salary US-MA-WestboroughJob Location 2 days ago(12/4/2025 8:17 AM)Requisition Number 2025-48959# of Openings 1Posted Date DayShift ExemptOverviewPOSITION SUMMARY: ForHealth Consulting at UMass Chan Medical School is seeking a detail-oriented Nurse Reviewer II with experience caring for...
-
Nurse Reviewer II-Case Mgt
6 days ago
Westborough, Massachusetts, United States ForHealth Consulting at UMass Chan Medical School Full timePosition SummaryForHealth Consulting at UMass Chan Medical School is seeking a detail-orientedNurse Reviewer IIwith experience caring for individuals with complex medical needs to join our Community Case Management Program. In this role, you will manage a caseload of members, ensuring they receive the long-term services and supports (LTSS) they need to...
-
Nurse Rev II-Case Mgt
3 weeks ago
Westborough, United States UMass Med School Full timeNurse Rev II-Case Mgt (Home Based with Client Visits) Minimum Salary US-MA-Westborough Job Location 2 weeks ago(11/9/2025 12:05 PM) Requisition Number 2025-48961 # of Openings 1 Posted Date Day Shift Exempt Overview Job SummaryUnder the general supervision of the Associate Director, Clinical Coordinator, or designee, the Nurse Reviewer II is responsible for...
-
Nurse Reviewer II-Case Mgt
3 weeks ago
Westborough, United States UMass Chan Medical School Full timeNurse Reviewer II Under the general supervision of the Associate Director, Clinical Coordinator, or designee, the Nurse Reviewer II is responsible for providing administrative case management as part of the Community Case Management Program. This position is responsible for the authorization, coordination and facilitation of long term services and supports...
-
Nurse Reviewer II-Case Mgt
3 weeks ago
Westborough, United States UMass Chan Medical School Full timeNurse Reviewer II Under the general supervision of the Associate Director, Clinical Coordinator, or designee, the Nurse Reviewer II is responsible for providing administrative case management as part of the Community Case Management Program. This position is responsible for the authorization, coordination and facilitation of long term services and supports...
