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Manager, Utilization Review

Mass General Brigham (Enterprise Services)
United States, Massachusetts, Somerville
399 Revolution Drive (Show on map)
Apr 03, 2025
The Manager of Utilization Review is accountable for the delivery of consistent, high-quality patient care, promoting the development and satisfaction of Utilization Review nurses and support staff, providing operational efficiencies and insuring compliance with hospital and utilization management regulatory policies and standards of practice. The Manager of Utilization Review develops and implements department initiatives to enhance the evolving role of the Utilization Management. The Manager of Utilization Review provides leadership across multiple hospitals within the system. The role ensures patient-focused Utilization Management standards of practice, personnel management and development, and fiscal responsibility. In addition to daily operations, the role maintains and cultivates partnerships with numerous clinical and non-clinical services/departments within the organization through participation in Case Management, Revenue Cycle, Contracting, and MGB Payer groups, committees and initiatives. Bachelor's Degree in Nursing required, Master's Degree in Nursing or Social Work preferred. Registered Nurse [RN - State License] 3-5 years utilization review experience required 2-3 years leadership experience required Knowledge, Skills and Abilities: Excellent team communication skills. Strong interpersonal skills, with the ability to develop, motivate and inspire a team. Strong team player that is able to multitask with multiple interruptions in a deadline-intense environment. Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions. Understanding the implications of new information for both current and future problem-solving and decision-making. Mass General Brigham Incorporated is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.