Utilization Management Nurse

Mass General Brigham Health Plan Holding Company, Inc.

Somerville, MA, US
$90,000 to $107,000 annually; base: $58,656.00 - $...
Fully remote
Clinical review
Authorization requests
Managed care setting
The UMCM will utilize clinical knowledge to analyze, assess, and render approval decisions, to determine the need for physician review as well as complete determinations following physician review

Job Summary

  • The UMCM will utilize clinical knowledge to analyze, assess, and render approval decisions, to determine the need for physician review as well as complete determinations following physician review.
  • Mass General Brigham Health Plan is an exciting place to be within the healthcare industry, offering competitive salaries and a benefits package with flexible work options, career growth opportunities, and much more.
  • The company is committed to providing exceptional care and fostering groundbreaking medical discoveries through high-performing teams.

Matching Summary

The UMCM will utilize clinical knowledge to analyze, assess, and render approval decisions, to determine the need for physician review as well as complete determinations following physician review.

Salary

$90,000 to $107,000 annually; Base: $58,656.00 - $142,448.80/Annual; Benefits: Comprehensive benefits package

Skills & Requirements

Must-have

  • clinical review
  • authorization requests
  • managed care setting
  • Interqual
  • payer setting
  • Microsoft Word, Excel, Outlook

Nice-to-have

  • challenging conventions
  • inject energy
  • act with ownership
  • people-first organization
  • strong EQ

Key Requirements

  • Associate's Degree Nursing required
  • Massachusetts Registered Nurse (RN) license required
  • 2-3 years utilization review experience
  • 1-2 years payer setting experience
  • 1-2 years acute care setting experience

Work Rights

Not specified

Tailored Resume

Cover Letter