Manager, Medicare And Dsnp Utilization Management

Brigham and Women's Faulkner Hospital

Somerville, MA, USA
Base: $99,465.60 - $141,804.00/annual; bonus/equit...
Fully remote
Clinical utilization management experience
Medicare advantage and d-snp knowledge
Team supervision of care coordinators
The role involves overseeing clinical utilization management activities to ensure efficient resource use for Medicare Advantage and D-SNP members

Job Summary

  • The role involves overseeing clinical utilization management activities to ensure efficient resource use for Medicare Advantage and D-SNP members.
  • Candidates will manage a team of clinical professionals while collaborating with various departments to improve patient outcomes and streamline care processes.
  • The position offers competitive salaries, flexible work options, and career growth opportunities within a welcoming environment at Mass General Brigham.

Matching Summary

The role involves overseeing clinical utilization management activities to ensure efficient resource use for Medicare Advantage and D-SNP members.

Salary

Base: $99,465.60 - $141,804.00/Annual; Bonus/Equity: Not specified; Benefits: Comprehensive benefits package with flexible work options included

Skills & Requirements

Must-have

  • Clinical utilization management experience
  • Medicare Advantage and D-SNP knowledge
  • Team supervision of care coordinators
  • Long-Term Services and Supports expertise
  • Regulatory compliance monitoring

Nice-to-have

  • Strong leadership and team management skills
  • Excellent communication and interpersonal abilities
  • Analytical skills for patient data assessment
  • Problem-solving for complex care issues
  • Proficiency in healthcare management software

Key Requirements

  • Bachelor's Degree required
  • Master's Degree in Related Field preferred
  • Massachusetts Registered Nurse (RN) license required
  • 3-5 years in clinical care coordination or case management
  • 2-3 years in supervisory or leadership role
  • 2-3 years of Medicare and DSNP UM experience

Work Rights

Not specified

Tailored Resume

Cover Letter