Mass General Brigham Health Plan in Somerville, MA is seeking a clinical RN with UM experience to provide escalation support and triage inquiries, evaluating medical necessity and ensuring adherence to guidelines. You will collaborate with Nurse Reviewers, Medical Directors, and interdisciplinary teams to facilitate timely determinations.
The role emphasizes patient-centered care, regulatory compliance, and closure of complex cases.
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This position is listed as full time and onsite.