Utilization Management Nurse

Mass General Brigham Health Plan Holding Company, Inc.

Somerville, Massachusetts, USA
$90,000 to $107,000 annually; not specified; not s...
Fully remote
Clinical review
Authorization requests
Managed care setting
The UMCM will utilize clinical knowledge to analyze, assess, and render approval decisions, to determine the need for physician review as well as complete determinations following physician review

Job Summary

  • The UMCM will utilize clinical knowledge to analyze, assess, and render approval decisions, to determine the need for physician review as well as complete determinations following physician review.
  • Mass General Brigham Health Plan is an exciting place to be within the healthcare industry, at the forefront of transformation with one of the world’s leading integrated healthcare systems.
  • In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth.

Matching Summary

The UMCM will utilize clinical knowledge to analyze, assess, and render approval decisions, to determine the need for physician review as well as complete determinations following physician review.

Salary

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

Skills & Requirements

Must-have

  • clinical review
  • authorization requests
  • managed care setting
  • payer setting experience
  • Interqual usage

Nice-to-have

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

Key Requirements

  • Associate's Degree Nursing required
  • 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