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
Long-term services and supports (ltss)
Clinical care coordination
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).
  • Mass General Brigham Health Plan is at the forefront of transformation with one of the world’s leading integrated healthcare systems, providing innovative solutions centered on member health needs.
  • We are pleased to offer competitive salaries and a benefits package with flexible work options, career growth opportunities, and much more.

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
  • Long-Term Services and Supports (LTSS)
  • clinical care coordination
  • patient care processes and outcomes
  • healthcare management software

Nice-to-have

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

Key Requirements

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

Work Rights

Not specified

Tailored Resume

Cover Letter