Utilization Management Nurse

Mass General Brigham Health Plan Holding Company, Inc.

Somerville, MA, United States
$90,000 to $107,000 annually; not specified; not s...
Fully remote
Clinical review for utilization management
Prior authorization experience
Managed care setting
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

Job Summary

  • 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.
  • The Utilization Management Nurse will utilize clinical knowledge to analyze, assess, and render approval decisions, determining the need for physician review and completing determinations.
  • The company offers competitive salaries, a comprehensive benefits package, flexible work options, and career growth opportunities within a welcoming and supportive environment.

Matching Summary

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.

Salary

$90,000 to $107,000 annually; Not specified; Not specified

Skills & Requirements

Must-have

  • clinical review for utilization management
  • prior authorization experience
  • managed care setting
  • Interqual
  • commercial health plan knowledge
  • payer setting experience

Nice-to-have

  • strong aptitude for technology
  • ability to inject energy
  • exercise self-awareness
  • accountable for delivering high-quality work
  • bring fresh ideas forward

Key Requirements

  • Associate's Degree Nursing required
  • Bachelor's Degree Nursing preferred
  • 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