Utilization Management Nurse, Escalation Support
Mass General Brigham Health Plan Holding Company, Inc.
Somerville, Massachusetts
- Eligibility
- RNUtilization ReviewCase Management
- Shift
- Days
- Unit
- Utilization Management
Ask Mira
Posted Jul 23
The work and the unit
- Unit
- Utilization Management
- Specialty
- Utilization Management · Utilization Review · Case Management
- Setting
- Case Management
Schedule and commitments
- Shift
- Days
- Term
- Permanent
Pay and benefits
- Against the board
- Massachusetts staff median is $48/hrMassachusetts staff postings that state pay run $36/hr to $66/hr, the middle half $41/hr to $55/hr, across 413 postings. This posting states $28/hr to $68/hr, which is wider than that middle half, so where it sits depends on which end you are offered.
- Competitive salaries
- Benefits package
- Flexible work options
- Career growth opportunities
Do you qualify?
- License
- Massachusetts Registered Nurse (RN) license Check your license
What's around it?
Living costs about 6% above the US average
- Median rent
- $2,517/mo
- Household income
- $132,572/yr, all local households, not nurse pay
From Census ACS 2024.
About this role
Provides clinical review and escalation support for Utilization Management (UM) activities by triaging inquiries, calls, ticket submissions, and external requests - evaluating medical necessity, appropriateness of care, and compliance with regulatory and organizational guidelines. Collaborates with Nurse Reviewers, Medical Directors, providers, and interdisciplinary teams to address complex cases, facilitate timely determinations, and ensure accurate application of evidence-based criteria.
Sourced from a public job board.
How this role fits you
About the employer
You are looking at utilization management nursing for Mass General Brigham Health Plan Holding Company in Somerville—not a floor assignment, but full-time remote or partial home-office work reviewing authorizations, medical necessity, Interqual criteria, and prior auth for cases like IVF,…
Worth asking
- Can you walk me through differentials?
- What should I expect for weekly hours, weekend, holiday, call, and rotation?
More questions to askFewer questions
- What orientation, preceptor time, and ongoing unit support are included?
- How are patient load, floating, and staffing support handled day to day?
