2w
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Utilization Review Coordinator
Brookline, Massachusetts, United States
$69k-$94k/yr OnsiteFull Time
3+ YOEMaster's in psychology, social work or related field; 3+ years utilization review experience required (5 preferred); LCSW/LMHC/LICSW preferred.
1mo
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Utilization Review Clinician
Devens, Massachusetts, United States
$80k-$90k/yr OnsiteFull Time
Master's-level clinician or RN; experience with utilization management in inpatient psychiatric settings preferred; license eligible (LMHC or LICSW) or RN; strong communication and clinical/financial integration skills.
2d
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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
1mo
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Utilization Review Nurse - Per-Diem
Lawrence, Massachusetts, United States
$38-$76/hr OnsitePart Time, Temporary
5+ YOEBSN required (Master's preferred), Massachusetts RN license, minimum 5 years clinical nursing experience, case management/utilization review experience preferred, strong communication skills, and computer proficiency.
Interqual
1w
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Behavioral Health Utilization Manager (temporary)
Charlestown or Massachusetts or New Hampshire
$33-$49/hr RemoteFull Time, Temporary
5+ YOE5+ years behavioral health utilization management experience in health insurance; master’s in behavioral health field or BSN; BCBA required; BLS/CPR not mentioned; strong documentation, clinical judgment, and Microsoft Office skills.
Microsoft Outlook, Microsoft Word, Microsoft Excel
1w
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Physical Therapy Utilization Management Reviewer
Hingham, Massachusetts, United States
$42-$52/hr HybridFull Time
3+ YOEDPT/MSPT/BSPT from CAPTE program, Massachusetts licensure within 6 months, 3-5 years clinical experience, utilization management experience preferred, ability to assess clinical documentation, InterQual proficiency, and electronic clinical record skills.
InterQual
2w
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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
2w
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Customer Success Utilization Manager
Boston, Massachusetts, United States
$81k-$105k/yr FieldFull Time
1+ YOE2–3 years OR sales/service or 1+ year KARL STORZ video/integration experience; Bachelor's preferred; willingness to travel 50–80%+; good driving record; ability to work in OR environments.
Salesforce, OR1
1w
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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
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Behavioral Health Intake and Utilization Review Coordinator
Providence, Rhode Island, United States
OnsiteFull Time
2+ YOERN in Rhode Island with 2+ years behavioral health experience, knowledge of levels-of-care and utilization review, EHR proficiency, strong assessment, communication, and organizational skills.
MCG, InterQual, EHR, Microsoft Office Suite, API, Oracle, HealthStream, Meditech
2mo
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RN Utilization Review - Patient & Family Services - Per Diem
Nashua, New Hampshire, United States
OnsitePart Time
5+ YOERN with 5+ years experience; NH RN license; BSN required within 10 years; ASN accepted; on-site per diem weekends/holidays; experience with Interqual or similar criteria preferred.
Interqual, Milliman
1mo
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Water Treatment Operator II
Nashua, New Hampshire, United States
$36/hr OnsiteFull Time
2+ YOENHDES Treatment Operator I, 2 years operator experience, First Aid and OSHA 10 within 12 months, valid state driver's license, and ability to work rotating shifts.
1w
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Pollution Control Operator I or II (CT, South Windsor)
South Windsor, Connecticut, United States
OnsiteFull Time
Perform operation and maintenance of wastewater treatment and collection system equipment, collect samples, monitor SCADA (Operator II), operate vehicles, respond to emergency calls, and provide training (Operator II).
SCADA
1d
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Operator III - Water
Littleton, Massachusetts, United States
$33-$39/hr OnsiteFull Time
5+ YOEHigh school/GED, 3–5 years water-field experience, T-2 or D-2 water operator credential (or obtain within 6 months), OSHA 10, DOT medical card, computer literate in Windows/MS Office, available for on-call night and weekend work.
Microsoft Windows, Microsoft Office
3w
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Nurse Manager - Utilization Management (Full Time)
Burlington, Massachusetts, United States
$165k-$215k/yr OnsiteFull Time
3+ YOECurrent RN license, Bachelor's degree (Master's preferred), minimum 3 years medical/surgical nursing with leadership experience, knowledge of utilization management, payer regulations, quality improvement, and strong communication skills.
1mo
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Medical Director Utilization Management
United States or Boston
$240k-$250k/yr RemoteFull Time
5+ YOECompleted US residency/fellowship in Internal Medicine, MD or DO board certification, active state medical license, 5+ years clinical practice post-training, B2B managed care knowledge, clinical review experience desirable, comfortable with technology and able to obtain additional state licenses.
Payment Integrity Suite, Cohere Validate, ZignaAI
2mo
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Registered Nurse Case Manager (RN) - Utilization Management (Per Diem)
Willimantic, Connecticut, United States
OnsiteAll Commitments Available
5+ YOEThree years clinical nursing; two years in case management/discharge planning/utilization; Connecticut RN license; Bachelor's degree; MS Office; MIDAS experience a plus.
Microsoft Office, MIDAS
2mo
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Registered Nurse Case Manager (RN) - Utilization Management (Per Diem)
Willimantic, Connecticut, United States
OnsiteAll Commitments Available
3+ YOEThree years clinical nursing; two years in case management, discharge planning, utilization review, or home care; CT RN license; Bachelor's degree; MIDAS and MS Office experience preferred.
MIDAS software, Microsoft Office
1mo
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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
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Partner, AI-Enabled CDI, Care Management, and Utilization Management Transformation
Boston or Chicago or New York City or Washington or Nashville or United States
$250k-$350k/yr RemoteFull Time
10+ YOEBachelor's required (advanced preferred), 10+ years in CDI/care management/utilization management or healthcare consulting, deep knowledge of DRGs/denial prevention, EHR workflows, AI-enabled solutions, and strong executive communication.
Epic, NLP, EHR
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