Utilization Review Nurse

Brigham and Women(1 month ago)

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

About this role

The Utilization Management Clinical Manager (UMCM) at Mass General Brigham Health Plan is a nursing-based clinical role within the health plan that supports clinical decision-making and member care within managed care operations. The role sits on a multidisciplinary team in a not-for-profit health system and contributes to quality, compliance, and operational goals.

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Required Skills

Clinical Review
Prior Authorization
Utilization Management
InterQual
Medical Necessity
Patient Records
Communication
Problem Solving
Microsoft Office
Payer Knowledge

Qualifications

Associate's Degree Nursing
Bachelor's Degree Nursing
Massachusetts Registered Nurse (RN) 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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