Dsnp Utilization Management Nurse

Mass General Brigham Health Plan Holding Company, Inc.

United States of America
Base: $58,656.00 - $142,448.80/annual; bonus/equit...
Fully remote
Medicare advantage utilization management
Review authorization requests
Medical necessity review
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 Medicare UM Nurse performs utilization management activities primarily for Medicare Advantage, including review of authorizations for various services using specific criteria.
  • The organization offers competitive salaries, comprehensive benefits, flexible work options, career growth opportunities, and a commitment to recognizing and rewarding the unique value each team member brings.

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: $58,656.00 - $142,448.80/Annual; Bonus/Equity: Not specified; Benefits: Comprehensive benefits package

Skills & Requirements

Must-have

  • Medicare Advantage utilization management
  • Review authorization requests
  • Medical necessity review
  • NCD, LCD, Medicare Benefit Policy Manual

Nice-to-have

  • Exceptional member experience
  • Groundbreaking medical discoveries
  • Welcoming and supportive environment
  • Team member value recognition

Key Requirements

  • Associate's Degree Nursing required
  • Massachusetts Registered Nurse license required
  • 2-3 years utilization management preferred
  • InterQual experience preferred

Work Rights

Not specified

Tailored Resume

Cover Letter