Medicare Utilization Management Supervisor

Mass General Brigham Health Plan Holding Company, Inc.

Boston, MA, United States
Base: $99,465.60 - $141,804.00 annually; bonus/equ...
Fully remote
Massachusetts registered nurse license
Interqual software proficiency
Inpatient and outpatient utilization management expertise
The supervisor will oversee the daily operations of roughly five Medicare Advantage utilization management staff members while providing direct coaching and evaluation

Job Summary

  • The supervisor will oversee the daily operations of roughly five Medicare Advantage utilization management staff members while providing direct coaching and evaluation.
  • This role requires expert knowledge of clinical inpatient and outpatient utilization management reviews utilizing InterQual and company policies to ensure accuracy and timeliness.
  • Mass General Brigham offers competitive salaries, flexible work options, and a comprehensive benefits package for employees committed to advancing patient care and research.

Matching Summary

The supervisor will oversee the daily operations of roughly five Medicare Advantage utilization management staff members while providing direct coaching and evaluation.

Salary

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

Skills & Requirements

Must-have

  • Massachusetts Registered Nurse license
  • InterQual software proficiency
  • Inpatient and outpatient utilization management expertise

Nice-to-have

  • Certified Case Manager credential preferred
  • Leadership and supervisory experience
  • Collaborative team environment

Key Requirements

  • Bachelor's Degree in related field or equivalent experience
  • 3-5 years of managed care utilization management experience
  • Valid Massachusetts RN license required

Work Rights

Not specified

Tailored Resume

Cover Letter