Utilization Management Nurse

Mass General Brigham Health Plan Holding Company, Inc.

Somerville, MA, US
Base: $90,000 to $107,000 annually; bonus/equity: ...
Fully remote
Clinical review
Authorization requests
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.
  • This is a remote role offering competitive salaries, comprehensive benefits, career growth opportunities, and flexible work options.

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

Base: $90,000 to $107,000 annually; Bonus/Equity: Not specified; Benefits: Comprehensive benefits package

Skills & Requirements

Must-have

  • clinical review
  • authorization requests
  • managed care setting
  • Interqual
  • payer setting
  • remote role

Nice-to-have

  • challenging conventions
  • technology-based solutions
  • inject energy
  • strong EQ
  • people-first organization

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