Mass General Brigham Health Plan Holding Company, Inc.
Somerville, MA, United States
Base: $90,000 to $107,000 annually; bonus/equity: ...
Fully remote
Clinical review for utilization management
Analyze and assess medical services
Managed care setting experience
The Utilization Management Nurse will utilize clinical knowledge to analyze, assess, and render approval decisions, determining the need for physician review and completing determinations following physician review
Job Summary
The Utilization Management Nurse will utilize clinical knowledge to analyze, assess, and render approval decisions, determining the need for physician review and completing determinations following physician review.
Responsibilities include expertise in clinical review for prospective, concurrent, retrospective utilization management reviews utilizing Interqual®, company policies and procedures, and physician reviews as needed for all lines of business.
The company offers competitive salaries and a benefits package with flexible work options, career growth opportunities, and a commitment to creating an exceptional member experience.
Matching Summary
The Utilization Management Nurse will utilize clinical knowledge to analyze, assess, and render approval decisions, determining the need for physician review and completing determinations following physician review.
Salary
Base: $90,000 to $107,000 annually; Bonus/Equity: Not specified; Benefits: Comprehensive benefits package