Manager, Medicare And Dsnp Utilization Management

Mass General Brigham Incorporated

Somerville, MA, United States
Base: $99,465.60 - $141,804.00/annual; bonus/equit...
Fully remote
Clinical utilization management
Medicare advantage and dsnp
Care coordination strategies
Responsible for overseeing clinical utilization management (UM) activities to ensure efficient use of resources for Medicare Advantage and DSNP members

Job Summary

  • Responsible for overseeing clinical utilization management (UM) activities to ensure efficient use of resources for Medicare Advantage and DSNP members.
  • Supervise and support a team of care coordinators and case managers, ensuring they adhere to clinical standards and protocols.
  • 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.

Matching Summary

Responsible for overseeing clinical utilization management (UM) activities to ensure efficient use of resources for Medicare Advantage and DSNP members.

Salary

Base: $99,465.60 - $141,804.00/Annual; Bonus/Equity: Not specified; Benefits: comprehensive benefits package

Skills & Requirements

Must-have

  • clinical utilization management
  • Medicare Advantage and DSNP
  • care coordination strategies
  • patient care processes
  • healthcare management software

Nice-to-have

  • groundbreaking medical discoveries
  • exceptional member experience
  • welcoming and supportive environment
  • career growth opportunities

Key Requirements

  • Bachelor's Degree required
  • Massachusetts Registered Nurse [RN] license required
  • 3-5 years clinical care coordination/case management
  • 2-3 years supervisory/leadership role
  • 2-3 years Medicare and DSNP UM experience

Work Rights

Not specified

Tailored Resume

Cover Letter