Job Description

Salary: USD90000 - USD92000 per year Salary: $90,000–$92,000 per year Schedule: Monday–Friday, 8:30 AM–4:30 PM Location: Manchester, NH – Hybrid Work from Home: Monday & Tuesday | In Office: Wednesday–Friday Are you an experienced RN looking to get away from bedside nursing or transition out of the field as a Home Health Nurse? This could be a great opportunity to use your clinical knowledge in a Utilization Review role while gaining a more predictable schedule and improved work-life balance. We are seeking an experienced Registered Nurse (RN) to support Massachusetts workers’ compensation claims by reviewing medical treatment requests, evaluating medical records, and determining medical necessity and quality of care. What You'll Do Conduct utilization reviews for Massachusetts workers’ compensation claims. Review medical treatment requests, treatment plans, and supporting clinical documentation. Determine medical necessity and quality of care based on applicable regulations and clinical guidelines. Apply Massachusetts workers’ compensation guidelines, ODG, and other applicable state treatment guidelines. Review medical records that may contain up to approximately 200 pages. Identify and summarize relevant clinical information to support review determinations. Document clinical findings, rationale, and determinations accurately and thoroughly. Approve medically necessary services that support appropriate, quality patient care. Assist with medically complex treatment authorization requests. Consistently apply clinical guidelines, regulatory requirements, and established procedures. Productivity Expectations Average target of 10 utilization reviews per day . Typical daily volume of approximately 10–12 reviews , with volume potentially reaching 19 reviews depending on file volume and complexity. Workload varies based on the complexity and length of medical records. Required Qualifications Active RN license in New Hampshire. 2–3+ years of clinical nursing experience (Med/surg, Ortho, or Home Health) New graduates are not eligible for this position. Strong computer skills and ability to navigate multiple electronic systems. Strong clinical assessment, documentation, and analytical skills. Ability to review and interpret detailed medical records. Why Join Us? $90,000–$92,000 annual salary Excellent work-life balance with consistent daytime hours. Great opportunity to step away from bedside nursing while continuing to use your clinical expertise. Great opportunity for Home Health Nurses who are ready to transition out of field-based work . Family-started business with strong stability and long-term employee tenure. Many employees have been with the organization for 20+ years . Supportive, hands-on management team. Company-provided equipment, including: Laptop Company cell phone 4 monitors — 2 for home and 2 for the office Is This the Right Next Step for You? This role is a great fit for an experienced RN who wants to move away from the physical demands and pace of bedside nursing or who is ready to get out of the field after working in Home Health . If you enjoy using your clinical judgment, reviewing medical records, analyzing treatment plans, and applying clinical guidelines, this position allows you to leverage your nursing experience in a more structured office/remote environment . #J-18808-Ljbffr

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