Manager, Medicare And Dsnp Utilization Management

Mass General Brigham Incorporated

Somerville, MA, United States
Base: $99,465.60 - $141,804.00/annual; bonus/equit...
Fully remote
Medicare advantage and d-snp members
Long-term services and supports (ltss)
Clinical utilization management
Responsible for overseeing clinical utilization management (UM) activities to ensure efficient use of resources for Medicare Advantage and D-SNP members, including populations receiving Long-Term Services and Supports (LTSS)

Job Summary

  • Responsible for overseeing clinical utilization management (UM) activities to ensure efficient use of resources for Medicare Advantage and D-SNP members, including populations receiving Long-Term Services and Supports (LTSS).
  • Manages a team of clinical professionals, implements best practices, and collaborates with various departments to improve patient outcomes and streamline care processes.
  • Mass General Brigham Health Plan is an exciting place to be within the healthcare industry, at the forefront of transformation with one of the world’s leading integrated healthcare systems.

Matching Summary

Responsible for overseeing clinical utilization management (UM) activities to ensure efficient use of resources for Medicare Advantage and D-SNP members, including populations receiving Long-Term Services and Supports (LTSS).

Salary

Base: $99,465.60 - $141,804.00/Annual; Bonus/Equity: Not specified; Benefits: comprehensive benefits package

Skills & Requirements

Must-have

  • Medicare Advantage and D-SNP members
  • Long-Term Services and Supports (LTSS)
  • clinical utilization management
  • healthcare management software
  • electronic health record systems

Nice-to-have

  • groundbreaking medical discoveries
  • exceptional member experience
  • welcoming and supportive environment
  • flexible work options
  • career growth opportunities

Key Requirements

  • Bachelor's Degree required
  • Massachusetts Registered Nurse [RN] license required
  • 3-5 years clinical care coordination/case management
  • 2-3 years supervisory or leadership role
  • 2-3 years Medicare and DSNP UM experience

Work Rights

Not specified

Tailored Resume

Cover Letter