Utilization Management Nurse

Associate's Degree Nursing required or Bachelor's Degree Nursing preferred

Licenses and Credentials

Massachusetts Registered Nurse (RN) license required

​ Experience

At least 2-3 years of utilization review experience is highly preferred

Experience using Interqual or Milliman is highly preferred

At least 1-2 years of experience in a payer setting is highly preferred

At least 1-2 years of experience in an acute care setting is highly preferred

Knowledge, Skills, and Abilities

Demonstrate Mass General Brigham Health Plan’s core brand principles of always listening, challenging conventions, and providing value

Strong aptitude for technology-based solutions.

Embrace opportunities to take the complexity out of how we work and what we deliver.

Listen to our constituents, learn, and act quickly in our ongoing pursuit of meaningful innovation

Current in healthcare trends.

Ability to inject energy, when and where it’s needed.

Exercise self-awareness; monitor impact on others; be receptive to and seek out feedback; use self-discipline to adjust to feedback.

Be accountable for delivering high-quality work. Act with a clear sense of ownership.

Bring fresh ideas forward by actively listening to and working with employees and the people we serve.

Communicate respectfully and professionally with colleagues

Strong EQ; exercises self-awareness; monitors impact on others; is receptive to and seeks out feedback; uses self-discipline to adjust to feedback.

Additional Job Details (if applicable)

Would need to be available for “on call” for a minimum of once per month with the possibility of that increasing depending on staff availability; Approximately 6 months after hire.

This is a remote role with occasional onsite team meetings in Somerville, MA.

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EEO Statement:

At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.