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Contract Rn Case Review Jobs in Boston, MA (NOW HIRING)

Lynn Community Health Center

RN Case Manager

Lynn, MA · On-site

$35.50 - $47.78/hr

RN Case Manager - OBAT Services Summary: The Nurse Case Manager will provide clinical nursing support for Office Based Addiction Program and for the Integrated Primary Care Teams. The Nurse Case ...

Salter Healthcare

RN Case Manager

Winchester, MA

$45 - $55/wk

RN Case Manager Job Title: RN Case Manager Location: Winchester, Massachusetts Company Name: Winchester Rehabilitation and Nursing Center About the Role: As a dedicated and compassionate RN Case ...

South Shore Health

RN Case Manager per-diem

Weymouth, MA

$59.42 - $86.20/hr

Applies review criteria to determine medical necessity for admission and continued stay. Provides ... The RN Case Manager is an important resource in preventing delayed discharges of observation ...

South Shore Health

RN Case Manager per-diem

Weymouth, MA · On-site

$59.42 - $86.20/hr

Applies review criteria to determine medical necessity for admission and continued stay. Provides ... The RN Case Manager is an important resource in preventing delayed discharges of observation ...

South Shore Health

RN Case Manager per-diem

Weymouth, MA

$59.42 - $86.20/hr

Applies review criteria to determine medical necessity for admission and continued stay. Provides ... ESSENTIAL FUNCTIONS 1 - The RN Case Manager is responsible for reviewing the medical record of all ...

Longwood Hospice

Case Manager RN

Norfolk, MA

$40 - $53/hr

The RN Case Manager is responsible for providing nurse and hospice case management to hospice ... POC is up to date and reviewed at every team meeting. * Assess patient needs for necessary ...

ComForCare

RN Case Manager (PRN)

Lowell, MA · On-site

$45 - $50/hr

As our RN Case Manager, you'll be a problem-solver who brings peace of mind to those who need it ... and ComForCare does not accept, review or store my application. Any questions about your ...

ComForCare

RN Case Manager Homecare

Lowell, MA · On-site

$45 - $50/hr

As our RN Case Manager, you'll be a problem-solver who brings peace of mind to those who need it ... and ComForCare does not accept, review or store my application. Any questions about your ...

Cambridge Health Alliance

RN Case Manager

Cambridge, MA · On-site

$42 - $94.90/hr

Responsibilities include: - Review insurance claim denials and identify the reason for denial ... RN Case Management experience is required. Please note that the final offer may vary within the ...

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All JobsContract Rn Case Review JobsContract Rn Case Review Jobs in Boston, MA

Contract Rn Case Review information

See Boston, MA salary details

$20

$51

$86

How much do contract rn case review jobs pay per hour?

As of Jul 26, 2026, the average hourly pay for contract rn case review in Boston, MA is $51.64, according to ZipRecruiter salary data. Most workers in this role earn between $38.37 and $62.40 per hour, depending on experience, location, and employer.

How does a Contract RN Case Review professional typically collaborate with other healthcare team members?

As a Contract RN Case Review professional, you'll frequently coordinate with physicians, social workers, and other nursing staff to ensure comprehensive patient care. Collaboration often involves reviewing patient charts, discussing care plans, and providing recommendations for discharge planning or ongoing management. Effective communication is key, as you'll need to relay findings and updates to both internal teams and external case managers. This role often requires balancing independent, detailed review work with regular interdisciplinary meetings to drive optimal outcomes for patients.

What are the key skills and qualifications needed to thrive as a Contract RN Case Review, and why are they important?

To thrive as a Contract RN Case Review, you need a valid RN license, strong clinical judgment, and experience in case management or utilization review. Familiarity with medical coding systems (such as ICD-10, CPT), case management software, and knowledge of regulatory guidelines like Medicare and Medicaid are typically required. Excellent analytical thinking, attention to detail, and effective communication skills are crucial soft skills for this role. These competencies ensure accurate case assessments, compliance with healthcare regulations, and effective collaboration with providers and payers.

What is the difference between Contract Rn Case Review vs Contract Rn Case Management?

AspectContract Rn Case ReviewContract Rn Case Management
CertificationsRN license, case review certificationsRN license, case management certifications (e.g., CCM)
Work EnvironmentReviewing medical records, assessing casesCoordinating patient care, managing cases
Employer & IndustryInsurance companies, healthcare agenciesHealthcare providers, insurance companies
Search & Comparison IntentUnderstanding case review roles, job differencesExploring case management careers, job duties

Contract Rn Case Review focuses on evaluating medical records and determining coverage or compliance, while Contract Rn Case Management involves coordinating patient care and managing cases throughout treatment. Both roles require RN licensure, but they differ in daily tasks and responsibilities within the healthcare and insurance industries.

What is a Contract RN Case Review nurse?

A Contract RN Case Review nurse is a registered nurse who is hired on a contractual basis to evaluate patient cases, often for insurance companies, hospitals, or healthcare organizations. Their main duties include reviewing medical records, ensuring compliance with clinical guidelines, and providing recommendations for patient care or coverage decisions. These nurses typically work remotely or in office settings and may be responsible for communicating findings to healthcare providers or insurance adjusters. This role requires strong clinical knowledge, attention to detail, and excellent communication skills.
Contract Rn Case Review jobs near you

RN Case Review Coordinator - Faulkner

Massgeneralbrigham

Boston, MA • On-site

$41.36 - $100/hr

Full-time

Posted 7 days ago

Job description

Site: Brigham and Women's Faulkner Hospital, Inc.


Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.


Job Summary

Schedule: Full-time; 40 hours
Performs the six essential activities of Case Management: Assessment, Planning, Implementation, Coordinate, Monitor and Reassess through the continuum of care to facilitate a safe cost-effective transition post discharge. Performs all aspects of audits and appeals including the peer to peer process.
- Perform utilization review to evaluate for appropriate level of care and faxes all insurance reviews timely to prevent denials.
- Collaborate with patient/family and interdisciplinary team to assess for appropriate discharge needs.
- Place and implement all aspects of referrals to all levels of post acute care in 4 Next.
- Online documentation of interaction with patient, family and interdisciplinary team.
- Interact with various third party payers on a daily basis. Fax clinical in payor communication to the right insurer with the right fax number in the right time frame.
- Refer cases not meeting appropriate level of care to the Physician Advisor or EHR.
- Review for Observation status and make changes as needed. Accurately facilitate all documentation needed for Medicare status change inpatient to observation (code 44).
- Perform and monitor for quality issues and document in R.L. solutions.
- Provide to the patient or family member a copy of the Important Message
- Provide to the patient or representative the Observation Notification letter
- Provide to the patient representative the Acknowledgement of disclosure ,obtain choices of post acute facilities or service and signature
- Must be able to function independently in busy environment.
- Coordinate, complete and track all clinical denials and appeals.


Qualifications

  • BSN required.

  • Current Registration as a Licensed Nurse in the State of Massachusetts.

  • 3 year of Utilization Review and Case Management experience required, 4 or more years preferred

  • 5 years of Acute Care Nursing Required 6 or more preferred

  • CCM preferred.


Additional Job Details (if applicable)

About Brigham and Women's Faulkner Hospital

Brigham and Women's Faulkner Hospital is a non-profit, community teaching hospital located in Jamaica Plain directly across the street from the Arnold Arboretum. Founded in 1900, Brigham and Women's Faulkner Hospital offers comprehensive care in a wide variety of specialties. Brigham and Women's Faulkner Hospital is a designated Magnet hospital by the American Nurses Credentialing Center, a recognition that fewer than nine percent of all US hospitals receive.

At Brigham and Women's Faulkner Hospital, we believe that everyone should have the chance to live a healthy life. From creating breakthroughs that have paved the way for treatments around the globe to training the next generation of providers, our patients, and those we may never meet, are at the center of everything we do. If you're looking for more than a career, join Brigham and Women's Faulkner Hospital. Our patients call it better care. Our employees call it home.


Remote Type

Onsite


Work Location

1153 Centre Street


Scheduled Weekly Hours

40


Employee Type

Regular


Work Shift

Day (United States of America)


Pay Range

$41.36 - $100.00/Hourly


Grade

RN3500


At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.


EEO Statement:

2810 Brigham and Women's Faulkner Hospital, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.


Mass General Brigham Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

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