251 utilization management jobs at 121 companies in Boston, MA
1w
Save
Mark Applied
Hide
Epic Tapestry Utilization Management
Boston or Chicago or New York City or Washington or Nashville
$85-$95/hr RemoteContract, Temporary
Design, configure, implement, and support Epic Tapestry Utilization Management workflows; ensure regulatory compliance; perform testing and documentation; partner with clinical and operational teams.
Epic, Epic Tapestry, Tapestry Care Link, SmartTools, SmartText
2w
Save
Mark Applied
Hide
Supervisor, Utilization Management Support
United States or Waltham
$58k-$80k/yr RemoteFull Time
3+ YOE1+ Mgmt3+ years utilization management/prior authorization experience, 1+ year supervisory experience, Medicare Advantage experience, knowledge of PA workflows, EHR proficiency, AI/LLM workflow experience, strong communication and analytical skills.
EHR, AI/LLM
2d
Save
Mark Applied
Hide
Utilization Management Nurse BWH
Boston, Massachusetts, United States
$42-$106/hr RemotePart Time
Mass General Brigham: Provides integrated medical care, research, and clinical training services.
5+ YOEMassachusetts RN license, hospital or healthcare experience, utilization review and medical criteria experience, five years of medical or surgical nursing experience, and strong clinical, organizational, communication, and computer skills.
Milliman, InterQual
1w
Save
Mark Applied
Hide
Executive Director, Utilization Management
Boston, Massachusetts, United States
$180k-$210k/yr OnsiteFull Time
8+ YOE3+ Mgmt8+ years progressive UM/case management leadership, 3+ years multi-site senior leadership, bachelor\u0002s degree required (master\u0002s preferred), active RN license preferred, ACM/CCM preferred, experience with UM vendor management and regulatory compliance.
InterQual, MCG, Epic
3w
Save
Mark Applied
Hide
Sr Utilization Management Nurse RN - Remote
Boston, Massachusetts, United States
$73k-$130k/yr FieldFull Time
4+ YOEActive MA RN license, RAC/CT MDS certification prior to start, 4+ years nursing long-term care/record review, knowledge of Medicare/Medicaid and UM processes, HIPAA compliance, ability to travel across Massachusetts and reliable transportation.
Microsoft Office
1w
Save
Mark Applied
Hide
Wound Care Utilization Management RN
Indianapolis or Iselin or Tampa or Miami or Wilmington or Cincinnati or St. Louis or Walnut Creek or Las Vegas or Woburn or Grand Prairie or Chicago or California or Illinois or Massachusetts or Nevada or New Jersey
$39-$56/hr RemoteFull Time
3+ YOERequires an associate degree in nursing or equivalent background, 3+ years of healthcare experience, active unrestricted RN license, and wound-care certification such as WOCN or CWS.
medical records
1w
Save
Mark Applied
Hide
Haverhill Pavilion - Utilization Specialist
Haverhill, Massachusetts, United States
OnsiteFull Time
2+ YOEClinical experience with the facility population, high school diploma or equivalent; preferred clinical licensure (LPN,RN,LMSW,LCSW,LPC/LPC-I); CPR, de-escalation/restraint and first aid training; utilization management experience.
1mo
Save
Mark Applied
Hide
Director, Utilization Review
Exeter, New Hampshire, United States
$135k-$155k/yr OnsiteFull Time
5+ MgmtActive RN license, 5+ years utilization review leadership, knowledge of MCG and regulatory standards, experience with claims integration, and familiarity with interoperability/automation tools.
MCG, EDI
1mo
Save
Mark Applied
Hide
Manager, Scheduling and Utilization
Burlington or Cambridge
$127k-$140k/yr HybridFull Time
3+ YOEBachelor's in life sciences plus 3+ years (or Associate/GED plus 5+ years) in cGMP manufacturing, MS Office proficiency, OpCenter/MES experience preferred, Lean/Six Sigma certification within first year, strong communication and leadership skills.
OpCenter Execution Pharma, OpCenter APS, Siemens, Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Microsoft Project
4d
Save
Mark Applied
Hide
Utilization Review Coordinator - Part Time, 24 Hours/Week
Pembroke, Massachusetts, United States
$31-$46/hr OnsitePart Time
Current Massachusetts RN, LCSW, LICSW, or LMHC licensure and utilization management experience with a provider, insurer, or HMO are required; behavioral health experience is preferred.
CMS
5d
Save
Mark Applied
Hide
RN Manager Utilization Review- Full Time- Days
Manchester, New Hampshire, United States
OnsiteFull Time
Bachelor's degree or higher in nursing, active New Hampshire or compact-state RN license, utilization review and InterQual knowledge, and leadership skills; managerial experience and CCM or ACM certification preferred.
InterQual
1d
Save
Mark Applied
Hide
ABA Behavioral Health Utilization Manager (Outpatient and Non-24 Hour Diversionary Services)
Charlestown or Massachusetts
$70k-$101k/yr RemoteFull Time
5+ YOEMaster's in behavioral health or bachelor's in nursing; 5–7 years of behavioral health insurance experience, utilization management expertise, active MA and/or NH independent licensure, and BCBA credential.
Microsoft Outlook, Microsoft Word, Microsoft Excel
1d
Save
Mark Applied
Hide
Senior Business Transformation Product Manager - Utilization Management
Providence or Arizona or Connecticut or Florida or Georgia or Louisiana or Massachusetts or North Carolina or Oklahoma or Rhode Island or South Carolina or Texas or Virginia
$102k-$164k/yr RemoteFull Time
5+ YOERequires 5–7 years in product, operations, or transformation roles, cross-functional business and technology experience, strategic problem-solving, prioritization, stakeholder leadership, and measurable-results delivery.
AI, Blue Cross Blue Shield Association
2w
Save
Mark Applied
Hide
Senior Clinical Director, Medical Management
Boston, Massachusetts, United States
HybridFull Time
5+ YOE5+ Mgmt5+ years clinical and leadership experience in medical/utilization management, supervises clinical staff, Massachusetts RN/CNP/PA license, Bachelor’s degree, strong communication and regulatory knowledge.
1mo
Save
Mark Applied
Hide
Senior Data Scientist - Utilization Management
Wellesley or New York
$102k-$222k/yr HybridFull Time
3+ YOE3+ years analytic experience; programming in R or Python; experience with SQL; strong algorithm and predictive modeling knowledge; experience with LLMs/Generative AI preferred; bachelor’s degree or equivalent.
R, Python, SQL, LLMs, Generative AI
1mo
Save
Mark Applied
Hide
State Street Alpha Transaction Management Implementation Lead, Vice President
Boston, Massachusetts, United States
$115k-$205k/yr OnsiteFull Time
10+ YOE10+ years industry experience with front/middle/back office integration; strong knowledge of transaction management, financial instruments, DTCC/FX utilities, Power BI/Power Query, Microsoft Office, and Agile/SDLC tools.
DTCC CTM, DTCC Alert, FX Connect, XML, SWIFT, Microsoft Power BI, Power Query, Microsoft Co-Pilot, Microsoft Visio, Microsoft Project, Microsoft PowerPoint, JIRA, Rally, RTC, SDLC, Agile
5d
Save
Mark Applied
Hide
Senior Consultant - Organizational Change Management
Boston, Massachusetts, United States
$165k-$185k/yr OnsiteFull Time
9+ YOEBachelor’s degree and 9+ years of professional experience required, with utility consulting and organizational change management experience. Prosci certification, client-facing skills, and utility domain knowledge required.
Distributed Energy Resource Management System, Demand Response Management System, Geographic Information Systems, Outage Management System, Advanced Distribution Management System, Work Management, Automated Metering Infrastructure, Energy Management Systems, Information Technology (IT), Operational Technology (OT)
2w
Save
Mark Applied
Hide
Manager of Case Management, Case Management, 40-Hours, Days, 8:00am - 4:30pm, Monday - Friday, No weekends or holidays, Massachusetts RN License Required
Gardner, Massachusetts, United States
$45-$60/hr OnsiteFull Time
5+ YOEActive Massachusetts RN license, BSN required (must matriculate within 1 year if not), MSN preferred; prior management experience; 5+ years case management and 3+ years acute inpatient case management; utilization review experience.
InterQual
1w
Save
Mark Applied
Hide
Assistant Control Room Operator
West Wareham, Massachusetts, United States
$74k-$101k/yr OnsiteFull Time
Massachusetts Third Class Engineers License under Chapter 146, high school diploma or equivalent, and ability to monitor plant systems, respond to alarms, operate equipment, and follow emergency procedures.
computer networks
6d
Save
Mark Applied
Hide
Supervisor Meter Technical
Somerville or Waltham
$126k-$140k/yr OnsiteFull Time
5+ YOEFive-plus years of related experience, a bachelor's degree in electrical engineering, business, or equivalent experience, a valid driver's license, PC application skills, and metering knowledge.
Microsoft Word, Microsoft Excel, Email
Explore Jobs
Expand Your Job Search
Top Cities Near Boston for Utilization Management
- Utilization Management jobs in Worcester, MA
- Utilization Management jobs in Providence, RI
- Utilization Management jobs in Lowell, MA
- Utilization Management jobs in Cambridge, MA
- Utilization Management jobs in Manchester, NH
- Utilization Management jobs in Brockton, MA
- Utilization Management jobs in Fall River, MA
- Utilization Management jobs in Quincy, MA
- Utilization Management jobs in Lynn, MA
- Utilization Management jobs in Newton, MA
- Utilization Management jobs in Nashua, NH
- Utilization Management jobs in Warwick, RI
- Utilization Management jobs in Cranston, RI
- Utilization Management jobs in Somerville, MA
- Utilization Management jobs in Lawrence, MA
- Utilization Management jobs in Pawtucket, RI
- Utilization Management jobs in Framingham, MA
- Utilization Management jobs in Waltham, MA
- Utilization Management jobs in Haverhill, MA
- Utilization Management jobs in Malden, MA