Remote Utilization Management Nurse: Clinical Triage & Appeals
Mass General Brigham
Mass General Brigham Health Plan is seeking an experienced registered nurse for a remote Utilization Management role near Somerville, MA. You will triage inquiries, assess medical necessity, and collaborate with Nurse Reviewers, Medical Directors, providers, and teams to ensure timely determinations and compliant, evidence-based care. The role involves escalation of authorizations and coverage determinations, guiding staff on benefit interpretation, and identifying trends for process improvement
#J-18808-LjbffrVacancy posted 4 days ago
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