Remote RN Utilization Review Specialist

NeighborHealth’s SCO RN UM Reviewer role is based in East Boston within the Senior Care Options team. You will review clinical appeals and service authorization needs to ensure medical necessity aligns with CMS standards and organizational determinations. The role requires collaboration with RN Case Managers and the Medical Director to support timely decisions and effective patient care across a multi-site health plan. #J-18808-Ljbffr