Utilization Management Nurse

Mass General Brigham Health Plan

Mass General Brigham Health Plan is seeking a Registered Nurse to provide clinical review and escalation support for Utilization Management, triaging inquiries and ensuring medical necessity and regulatory compliance. This remote role supports our national network while collaborating with nurse reviewers, medical directors, and care teams. The position emphasizes timely determinations, evidence-based criteria, and member-centered care, with on-call obligations and occasional onsite meetings in #J-18808-Ljbffr

Apply

Vacancy posted 5 days ago

Similar jobs that could be interesting for youBased on the Utilization Management Nurse in Somerville, MA vacancy

Sr. Utilization Management Nurse - Field RN
...reimbursement, and high-quality patient care across skilled nursing and long-term care settings in Massachusetts. This is a... ...3+ years of clinical nursing experience ~ Experience in utilization management, medical record review, or long-term care ~ Strong understanding...
Suggested
Remote work
Weekend work
Weekday work
Optum
Boston, MA
5 days ago
Sr Utilization Management Nurse RN - Remote
$72.8k - $130k
...collaborative team scheduling and there is an occasional opportunity for remote work based on business needs. As a Sr Utilization Management Nurse in the Boston MA Regional Area, the role centers on ensuring the accuracy of medical record coding, supporting proper...
Suggested
Minimum wage
Full time
Work experience placement
Casual work
Live in
Work at office
Local area
Remote work
UnitedHealth Group
Boston, MA
1 day ago
Utilization Management Nurse Consultant
$26.01 - $68.55 per hour
...Utilization Management Nurse - Precertification RN Remote | Full-Time | Weekday Schedule Are you a clinically strong Registered Nurse who enjoys critical thinking and making evidence-based decisions? Join our Utilization Management team and play a key role in ensuring...
Suggested
Hourly pay
Full time
Temporary work
Local area
Remote work
Weekday work
Hispanic Alliance for Career Enhancement
Boston, MA
2 days ago
Travel RN (Registered Nurse) | Urgent Needs
$2,989 - $3,084 per week
...Registered Nurse (RN) | Utilization Review Location: Everett, MA Agency: GQR Healthcare Pay: $2,989 to $3,084 per week Shift... ...RN in Everett, Massachusetts, 02149! Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location:...
Suggested
Hourly pay
Weekly pay
Full time
Contract work
Immediate start
Shift work
TravelNurseSource
Everett, MA
1 day ago
Travel RN (Registered Nurse) | Urgent Needs
$2,989 - $3,084 per week
...Registered Nurse (RN) | Utilization Review Location: Everett, MA Agency: GQR Healthcare Pay: $2,989 to $3,084 per week Shift... ...Date: ASAP About the Position Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location:...
Suggested
Hourly pay
Weekly pay
Full time
Contract work
Immediate start
Shift work
GQR Healthcare
Everett, MA
1 day ago
Team Nurse (RN)
$89.18k
...Clinical Community Supports (ACCS) Team Nurse (Registered Nurse) promotes the full integration... ...live a healthy life in the community. Utilizing a holistic, person-centered approach,... ...Nurse will coordinate access to and management of health care for PS. The Team Nurse will...
Temporary work
Internship
Work at office
Flexible hours
Vinfen
Somerville, MA
3 days ago
Infusion Nurse
$38 - $40 per hour
...Job Summary Do you have a passion for nursing but are tired of the hectic, high-stress... ...Hyperbaric Oxygen Therapy sessions. Utilize blood test offerings to help clients optimize... ...hiring decisions will be made by the management of this franchisee. All inquiries about...
Hourly pay
Work at office
Restore Hyper Wellness
Somerville, MA
4 days ago
Travel Nurse RN - Labor & Delivery - $2,808 per week in Cambridge, MA
$2,808 per week
...Registered Nurse (RN) | Labor & Delivery Location: Cambridge, MA Agency: FlexCare Pay: $2,808 per week Shift Information... ...leader in travel nursing, allied health, and therapy talent management solutions for top healthcare facilities throughout the U.S....
Full time
Contract work
Immediate start
Shift work
Rotating shift
TravelNurseSource
Cambridge, MA
1 day ago
Travel Nurse RN - Case Manager, Utilization Review - $2,250 per week
$2,250 per week
...AMN Healthcare Revenue Cycle is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Allston, Massachusetts. Job Description & Requirements ~ Specialty: Utilization Review ~ Discipline: RN ~ Start Date: 08/24/2026...
Temporary work
Immediate start
Shift work
AMN Healthcare Revenue Cycle
Allston, MA
4 days ago
Genetics Advanced Practice Nurse
...including diagnostics, genetic counseling, and individualized management in concert with other specialties for people of all ages. Our... ...program includes more than 30 board-certified clinical geneticists, nurse practitioners and registered nurses, genetic counselors and...
Flexible hours
Boston Children's Hospital
Brookline, MA
11 hours ago
Charge Registered Nurse - RN
$85.7k - $142.79k
...SCOPE: Works with the Facility Manager, facility staff and physician to... ...policies, procedures and training. Provides nursing support to patients and staff. Assists with... ...manner and the facility capacity is utilized efficiently. As needed, assist with patient...
Work experience placement
Work at office
Local area
Immediate start
Fresenius Medical Care
Saugus, MA
3 days ago
ED RN Case Manager - Inpatient Case Management CH
...: CHA Cambridge Hospital Category : Registered Nurse Department : Inpatient Case Management CH Job Type : Full time Union Name : MNA Cambridge... ...of the health care team to identify appropriate utilization of resources and to ensure reimbursement. Utilize...
Full time
Local area
Work from home
Shift work
Weekend work
Day shift
Cambridge Health Alliance
Cambridge, MA
11 hours ago
School Nurse
...Type: Student Support Services/School Nurse Date Posted: 8/5/2026 Location:... ..., planning, evaluation, counseling, management and/or referrals concerning the health and... ...interpret health problems, to assist parents in utilization of professional resources for diagnosis...
Contract work
Work at office
Medford Public Schools
Medford, MA
2 days ago
Travel Nurse RN - Administration / Management in Boston, MA
...Registered Nurse (RN) | Administration / Management Location: Boston, MA Agency: Titan Medical Group Pay: Competitive weekly pay (inquire for details) Shift Information: Days - 5 days x 8 hours Contract Duration: 12 Weeks Start Date: 8/31/...
Weekly pay
Full time
Contract work
Shift work
Titan Medical Group
Boston, MA
1 day ago
Travel Nurse RN - Administration / Management in Boston, MA
...Registered Nurse (RN) | Administration / Management Location: Boston, MA Agency: Titan Medical Group Pay: Competitive weekly pay (inquire for details) Shift Information: Days - 4 days x 10 hours Contract Duration: 12 Weeks Start Date: 9/6/...
Weekly pay
Full time
Contract work
Shift work
TravelNurseSource
Boston, MA
1 day ago
Travel Nurse RN - Administration / Management in Boston, MA
...Registered Nurse (RN) | Administration / Management Location: Boston, MA Agency: Titan Medical Group Pay: Competitive weekly pay (inquire for details) Shift Information: Days - 5 days x 8 hours Contract Duration: 12 Weeks Start Date: 8/31/...
Weekly pay
Full time
Contract work
Shift work
TravelNurseSource
Boston, MA
1 day ago
Travel Nurse RN - Administration / Management in Boston, MA
...Registered Nurse (RN) | Administration / Management Location: Boston, MA Agency: Titan Medical Group Pay: Competitive weekly pay (inquire for details) Shift Information: Days - 4 days x 10 hours Contract Duration: 12 Weeks Start Date: 9/6/...
Weekly pay
Full time
Contract work
Shift work
Titan Medical Group
Boston, MA
1 day ago
RN Care Manager
$44 per hour
...of our patients and communities. Whether you're a nurse or physician providing direct care, a manager leading dedicated teams, or part of the essential... ...that supports our local community. Additionally, we utilize our Education & Training Institute as a resource for...
Hourly pay
Full time
Fixed term contract
Work at office
Local area
Immediate start
Monday to Friday
Flexible hours
East Boston Neighborhood Health Center
East Boston, MA
1 day ago
Registered Nurse, Infusion and Day Treatment (IDT) Program
...replacement Food and drug allergy challenges and desensitization Management of outpatient PICC line complications Diagnostic endocrine... ...Qualifications Education: ~ A Bachelor's degree in nursing. Experience: Minimum of 2 years of RN experience;...
Flexible hours
Rotating shift
Weekend work
Afternoon shift
Boston Children's Hospital
Boston, MA
11 hours ago
RN Ambulatory Health Primary Care
...psychological care and counseling. Our team is made up of physicians, nurse practitioners, nurses, dietitians, mental health providers, and... ...Program , the Boston HAPPENS HIV program , the STEP weight management program , the Long-acting Reversible Contraception (LARC)...
Monday to Friday
Flexible hours
Shift work
Boston Children's Hospital
Boston, MA
11 hours ago
RN Care Coordinator (Per Diem)
$41.77 - $98.41 per hour
...POSITION SUMMARY : Utilizing a collaborative process, the care manager will assess, plan, implement, monitor, and evaluate the options and services required... ...Per Diem JOB REQUIREMENTS: Education: ~ Nursing degree: Diploma, ASN or BSN (preferred), Ability to...
Daily paid
Contract work
Fixed term contract
Flexible hours
St. Elizabeth’s Medical Center
Brighton, MA
5 days ago
RN Case Manager
...Summary: Uniti Med is looking for a Registered Nurse (RN) in Everett, Massachusetts. This assignment lasts... ...Referral bonus up to $700 Registered Nurse (RN),Case Management/Utilization Review, About the Company: Uniti Med is an award...
Hourly pay
Weekly pay
Temporary work
Immediate start
UnitiMed
Everett, MA
1 day ago
Travel Nurse RN - Case Manager - $1,157 per week in Cambridge, MA
$1,157 per week
...Registered Nurse (RN) | Case Manager Location: Cambridge, MA Agency: Prime Staffing Pay: $1,157 per week Shift Information:... ...perfect fit for both our clients and candidates. Prime Staffing utilizes a unique matchmaking approach, providing the most...
Permanent employment
Full time
Contract work
Temporary work
Local area
Shift work
Afternoon shift
TravelNurseSource
Cambridge, MA
1 day ago
Hospice RN Case Manager
$83.84k - $120k
...difference in people's lives. Job Description: What You'll Do : The Hospice RN Case Manager plans and delivers care to patients utilizing the nursing process of assessment, planning, intervention, implementation, and evaluation; and effectively...
Beth Israel Lahey Health
Watertown, MA
3 days ago
Nurse Care Manager
$78.58k - $117.86k
...risk and provide intensive, individualized case management and support as needed and desired by the resident. The Nurse Care Manager is a key member of the housing... ...changes in status, transitions, and service utilization. Active follow-up on all hospitalizations,...
Remote work
Flexible hours
Hebrew SeniorLife
Arlington, MA
5 days ago
Registered Nurse - ICU - Relocation to Glens Falls, NY
$37 - $61.74 per hour
...shared coverage for overnight shifts. We utilize a collaborative scheduling system to ensure... ...remains fair and predictable for all nursing staff. Why Join The Glens Falls Hospital... ...level of an ICU. Nurses typically manage a lower patient ratio compared to standard...
Hourly pay
Relocation
Relocation package
Shift work
Night shift
Glens Falls Hospital
Belmont, MA
5 days ago
Registered Nurse, ED
$42.36 - $56.99 per hour
...role is considered the minimum role for all nurses who have greater than 12 months... ...multidisciplinary patient care services team. Utilizes the institution’s care delivery and professional... ...for care provided and to the nurse manager for totality of work performance. Is accountable...
Full time
Work experience placement
Relocation package
Shift work
University of Maryland Medical System
Cambridge, MA
3 days ago
Home Care RN - PRN
$40.61 - $60.96 per hour
...changes or additions. # Communication and Multidisciplinary Management: Works closely with physicians as primary patient liaison to support... ...ability to plan and organize time; the ability to effectively utilize resources to meet patient needs. Excellent communication, and...
Full time
Work experience placement
Relief
Work at office
Shift work
University of Maryland Medical System
Cambridge, MA
3 days ago
Registered Nurse (Weekend & PRN Weekday Shifts)
$45 per hour
...patients via therapeutic use of self, the nursing process, the environment/technology, and... ...; engaged in advancing own practice. Utilizes and integrates evidence into practice.... ...adverse events and near misses to appropriate management authority. 3. Identifies possible...
Price work
Full time
Relief
Shift work
Weekend work
Weekday work
University of Maryland Medical System
Cambridge, MA
4 days ago
Registered Nurse - Nursing NICU
...NICU Registered Nurse MedPro Healthcare Staffing, a Joint Commission-certified staffing... ...ability to make clinical judgments and utilize critical thinking in an effective and efficient... ...nursing standards and is accountable in managing patient care and assisting others in the...
Weekly pay
Contract work
MedPro Healthcare Staffing
Brighton, MA
3 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Utilization Management Nurse. Be the first to apply!