Utilization Management Care Manager

Brigham and Women(1 month ago)

RemoteFull TimeMedior$58,656 - $142,448.8Utilization Management

About this role

A clinical nursing role within Mass General Brigham Health Plan that applies nursing background to support utilization management and authorization decision-making in a managed care environment. The position emphasizes familiarity with Medicaid/MassHealth and prior authorization processes and operates primarily remotely with occasional onsite meetings.

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Required Skills

Clinical Review
Prior Authorization
InterQual
Utilization Management
Medical Necessity
Patient Records
Communication
Problem Solving
Customer Service
MS Office

Qualifications

Associate's Degree Nursing
Bachelor's Degree Nursing
Massachusetts Registered Nurse License

About Brigham and Women

brighamandwomens.org

Brigham and Women’s Hospital is one of the top hospitals in America with more than 790 beds, and a premier teaching hospital of Harvard Medical School. Learn more.

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