Mass General Brigham Health Plan Holding Company, Inc. is seeking a clinician to provide clinical review and escalation support for Utilization Management (UM) activities.
You will triage inquiries, assess medical necessity, and ensure regulatory compliance while collaborating with Nurse Reviewers, Medical Directors, providers, and interdisciplinary teams. The role requires an RN license in Massachusetts and 2-3 years of case management experience, with on-call availability for monthly shifts.
#J-18808-LjbffrClinical Escalation Nurse - Utilization Management (Remote) in workfromhome at Unknown Company
This position is listed as full time and onsite.