41 utilization management nurse jobs at 17 companies in Boston, MA
1w
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
Utilization Nurse
Plymouth, Massachusetts, United States
$37-$82/hr OnsitePart Time
3+ YOECurrent Massachusetts RN license, three years of broad hospital clinical experience, and utilization management experience within the last three years; InterQual knowledge required.
InterQual, Allscripts
1mo
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
2w
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
1d
Save
Mark Applied
Hide
Utilization Review Coordinator
Concord, Massachusetts, United States
$45-$65/hr OnsiteFull Time
3+ YOERN licensure and 3 years of hospital case management or utilization management experience required; BSN preferred. Must monitor utilization, coordinate clinical reviews, and address potential denials.
1w
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
2mo
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
1w
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
1mo
Save
Mark Applied
Hide
Registered Nurse, Homecare
Warwick, Rhode Island, United States
OnsiteFull Time
5+ YOEBachelor of Nursing and RN license required, minimum 5 years clinical experience, experience with case management, utilization review, and discharge planning.
1mo
Save
Mark Applied
Hide
Registered Nurse, Care Manager
Warwick, Rhode Island, United States
OnsiteTemporary
2+ YOEActive unrestricted Rhode Island RN license, graduate of accredited nursing school; bachelor’s in nursing preferred; minimum 2 years recent acute care experience; knowledge of case management, utilization review, quality assurance; CCM or ACM certification required or to be obtained within 24 months.
InterQual, ICD 10
2mo
Save
Mark Applied
Hide
Registered Nurse, Care Manager
Warwick or Providence
OnsiteContract, Part Time
2+ YOEActive Rhode Island RN license, 2+ years recent acute care experience, knowledge of case management and utilization review, CCM or ACM certification within 24 months preferred, bachelor\u0002s or master\u0002s degree preferred, strong communication and leadership skills.
InterQual, SIMS Plus, ICD-10, Crimson
3w
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
2mo
Save
Mark Applied
Hide
RN Case Manager, Inpatient Cardiology
Boston, Massachusetts, United States
$94k-$150k/yr OnsiteFull Time
5+ YOEBachelor of Nursing required, 5+ years nursing experience (pediatrics preferred), Massachusetts RN license required, CCM preferred or willing to obtain, experience in discharge planning/utilization management.
1mo
Save
Mark Applied
Hide
RN Care Coordinator (Per Diem)
Brighton, Massachusetts, United States
$41-$95/hr OnsitePart Time, Temporary
2+ YOEActive Massachusetts RN license, BLS required; 2 years med-surg, 1 year discharge planning, 2 years case/utilization management experience; nursing degree (diploma/ASN/BSN; BSN preferred); InterQual experience preferred.
InterQual, ICD-9, CPT
2d
Save
Mark Applied
Hide
RN Case Manager
Weymouth, Massachusetts, United States
$118k-$171k/yr OnsiteFull Time
3+ YOERequired RN license; 3–5 years acute-care experience preferred. ACM or CCM required within two years. Requires case management, utilization management, communication, negotiation, critical thinking, and discharge planning skills.
InterQual, EHR, eDischarge, MCCM, Epic, Workday, SBAR, Lean
5d
Save
Mark Applied
Hide
Case Manager (NE)
North Providence, Rhode Island, United States
OnsitePart Time
Nursing graduate with a current RN license in Rhode Island or a Nurse Licensure Compact state. Case management, utilization review, discharge planning, and InterQual or MCG experience required or preferred.
Care Port, InterQual, MCG, Meditech
2w
Save
Mark Applied
Hide
RN Case Manager
Hingham, Massachusetts, United States
$44-$54/hr RemoteFull Time
3+ YOEActive Massachusetts RN license required, 3-5 years clinical experience, utilization management preferred, ability to assess needs, coordinate care, and document care plans.
1w
Save
Mark Applied
Hide
Case Mgr - Beh Health
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
$74k-$110k/yr RemoteFull Time
3+ YOERequires an unrestricted RN, doctoral psychologist, LMHC, or LICSW license; 3–5 years of clinical or managed-care experience; CCM certification within three years; utilization management and care coordination knowledge.
Employee Assistance, FEP
2d
Save
Mark Applied
Hide
RN Case Manager - Milford Regional, Per Diem
Milford, Massachusetts, United States
$40-$85/hr OnsitePart Time
3+ YOEBSN, current Massachusetts RN license, 3–5 years of clinical experience, utilization review, quality assurance, or community experience, plus strong interpersonal and analytical skills.
2mo
Save
Mark Applied
Hide
Director, Medical Policy
Canton, Massachusetts, United States
$162k-$243k/yr HybridFull Time
10+ YOE5+ MgmtRequires active RN licensure, Bachelor's degree (Master's preferred), 10+ years in medical policy/utilization/quality improvement with 5 years managerial experience, policy and regulatory expertise, strong communication and analytic skills.
Explore Jobs
Expand Your Job Search
Top Cities Near Boston for Utilization Management Nurse
- Utilization Management Nurse jobs in Worcester, MA
- Utilization Management Nurse jobs in Providence, RI
- Utilization Management Nurse jobs in Lowell, MA
- Utilization Management Nurse jobs in Cambridge, MA
- Utilization Management Nurse jobs in Manchester, NH
- Utilization Management Nurse jobs in Brockton, MA
- Utilization Management Nurse jobs in Fall River, MA
- Utilization Management Nurse jobs in Quincy, MA
- Utilization Management Nurse jobs in Lynn, MA
- Utilization Management Nurse jobs in Newton, MA
- Utilization Management Nurse jobs in Nashua, NH
- Utilization Management Nurse jobs in Warwick, RI
- Utilization Management Nurse jobs in Cranston, RI
- Utilization Management Nurse jobs in Somerville, MA
- Utilization Management Nurse jobs in Lawrence, MA
- Utilization Management Nurse jobs in Pawtucket, RI
- Utilization Management Nurse jobs in Framingham, MA
- Utilization Management Nurse jobs in Waltham, MA
- Utilization Management Nurse jobs in Haverhill, MA
- Utilization Management Nurse jobs in Malden, MA