Clinical nurse rn Jobs in Lowell ma

A company is looking for a Clinical Quality RN to support quality audit activities for operational clinicians and health plan partners.Key ResponsibilitiesReview Prior Authorization, Inpatient Concurrent Review, and Medical Claims Review cases as assignedDocument observations and feedback on cases using structured scorecards and credible sourcesCommunicate effectively with peers, leaders, and auditors while suggesting process improvementsRequired QualificationsActive, unrestricted RN license in state of residenceKnowledge of Curo and Care Advance medical management platformsExperience with Prior Authorization, inpatient concurrent review, or medical claims reviewIntermediate proficiency with basic software applications including MS Office and AdobeKnowledge of CMS clinical guidelines, MCG, and InterQual