Utilization Management Transitions Of Care Coordinator

Mass General Brigham Health Plan Holding Company, Inc.

Remote, United States
Base: $79,560.00 - $115,720.80/annual; bonus/equit...
Fully remote
2-3 years health plan clinical services experience
2-3 years direct clinical experience required
Strong understanding of levels of care continuum
Mass General Brigham Health Plan is seeking a Utilization Management Transitions of Care Coordinator for a fully remote position. The role focuses on facilitating seamless transitions of care for patients, requiring a strong background in clinical services and utilization management

Job Summary

  • This role serves as the single point of contact for facilities and providers to resolve barriers during complex discharge and transition plans.
  • Candidates must demonstrate a solid managed care understanding including how authorizations and medical necessity impact placement decisions.
  • The position offers competitive salaries, flexible work options, and career growth opportunities within a welcoming supportive environment.

Matching Summary

Match Score: 85

Mass General Brigham Health Plan is seeking a Utilization Management Transitions of Care Coordinator for a fully remote position. The role focuses on facilitating seamless transitions of care for patients, requiring a strong background in clinical services and utilization management.

Salary

Base: $79,560.00 - $115,720.80/Annual; Bonus/Equity: Not specified; Benefits: Comprehensive benefits package with flexible work options

Skills & Requirements

Must-have

  • 2-3 years health plan clinical services experience
  • 2-3 years direct clinical experience required
  • Strong understanding of levels of care continuum
  • Proficient in electronic health records (EHR)
  • Knowledge of utilization management criteria

Nice-to-have

  • Excellent verbal and written communication abilities
  • Strong analytical and critical thinking skills
  • Ability to handle sensitive information confidentially
  • Experience with appeals and grievance processes
  • Collaborative interdisciplinary team player

Key Requirements

  • Massachusetts Registered Nurse (RN) license preferred
  • Associate's Degree Nursing or Bachelor's Healthcare Administration
  • Bachelor's Degree Related Field of Study required
  • At least 2-3 years experience in utilization management
  • Remote work eligibility from most US states

Work Rights

Not specified

Tailored Resume

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