Manager, Medicare And Dsnp Utilization Management

Mass General Brigham Health Plan Holding Company, Inc.

Somerville, MA, United States
Base: $99,465.60 - $141,804.00/annual; bonus/equit...
Fully remote
Supervise clinical care coordinators
Implement clinical care strategies
Monitor patient care processes
The role involves overseeing clinical utilization management to ensure efficient resource use for Medicare Advantage and D-SNP members including those receiving Long-Term Services and Supports

Job Summary

  • The role involves overseeing clinical utilization management to ensure efficient resource use for Medicare Advantage and D-SNP members including those receiving Long-Term Services and Supports.
  • Candidates will supervise a team of care coordinators and case managers while implementing best practices to streamline care processes and improve patient outcomes.
  • Mass General Brigham offers competitive salaries, flexible work options, and career growth opportunities within a welcoming environment that supports employee development.

Matching Summary

The role involves overseeing clinical utilization management to ensure efficient resource use for Medicare Advantage and D-SNP members including those receiving Long-Term Services and Supports.

Salary

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

Skills & Requirements

Must-have

  • Supervise clinical care coordinators
  • Implement clinical care strategies
  • Monitor patient care processes
  • Analyze patient data trends
  • Manage case load assignments

Nice-to-have

  • Collaborate with healthcare providers
  • Facilitate team collaboration
  • Improve operational efficiency
  • Support diverse backgrounds
  • Embrace unique experiences

Key Requirements

  • Bachelor's Degree required
  • Master's Degree in Related Field preferred
  • Massachusetts Registered Nurse license required
  • 3-5 years clinical care coordination experience
  • 2-3 years supervisory leadership experience
  • 2-3 years Medicare and DSNP UM experience
  • LTSS experience preferred

Work Rights

Not specified

Tailored Resume

Cover Letter