Utilization Management Nurse BWH
Brigham and Women(10 days ago)
About this role
The Staff Nurse at Brigham and Women's Hospital specializes in managing insurance denials through utilization management and denial processes. The role involves collaborating with various departments to ensure proper care authorization, handling appeals, and supporting the care coordination team. It emphasizes clinical assessment, insurance knowledge, and team collaboration to facilitate timely case resolution.
Required Skills
- Nursing
- Utilization Review
- Medical Criteria
- Insurance Claims
- Denial Management
- Care Coordination
- Interqual
- Milliman
- Clinical Assessment
- Medicare
Qualifications
- Bachelor's Degree Nursing
- Massachusetts Registered Nurse
About Brigham and Women
brighamandwomens.orgBrigham 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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