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Remote Utilization Nurse - Impactful Care Decisions
Remote / Online - Candidates ideally in
Washington, District of Columbia, 20022, USA
Listed on 2026-08-26
Washington, District of Columbia, 20022, USA
Listing for:
Santa Barbara Cottage Hospital
Remote/Work from Home
position Listed on 2026-08-26
Job specializations:
-
Nursing
RN Nurse
Job Description & How to Apply Below
Mass General Brigham Health Plan Holding Company, Inc. is seeking an RN-based Utilization Management Nurse to support network adequacy reviews and authorization decisions for ACO, HMO, and EPO products.
The role emphasizes medical necessity assessment and robust payer knowledge. The position requires an Associate's or Bachelor's in Nursing and a Massachusetts RN license, with 2–3 years in utilization review and familiarity with Inter Qual or Milliman.
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