RN Utilization Management Reviewer

The RN Utilization Management Reviewer facilitates care for members with complex healthcare needs by authorizing medically necessary services to ensure appropriate levels of care and optimal health. The role operates independently and collaboratively within a multidisciplinary team, applying managed care principles, medical necessity criteria, and company policies. This position is with Blue Cross Blue Shield of Massachusetts and is eligible for remote work with occasional on-site presence in Hingham, MA.