Remote Utilization Management Nurse: Clinical Escalations
Remote / Online - Candidates ideally in
Somerville, Middlesex County, Massachusetts, 02145, USA
Listed on 2026-08-05
Somerville, Middlesex County, Massachusetts, 02145, USA
Listing for:
Mass General Brigham Health Plan
Remote/Work from Home
position Listed on 2026-08-05
Job specializations:
-
Nursing
Clinical Nurse Specialist, Healthcare Nursing, Emergency Medicine
Job Description & How to Apply Below
Mass General Brigham Health Plan is seeking a Registered Nurse to provide clinical review and escalation support for Utilization Management, triaging inquiries and ensuring medical necessity and regulatory compliance. This remote role supports our national network while collaborating with nurse reviewers, medical directors, and care teams.
The position emphasizes timely determinations, evidence-based criteria, and member-centered care, with on-call obligations and occasional onsite meetings in
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