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Massachusetts Licensed Nurse Manager
A company is looking for a Nurse Manager for Utilization Review and Clinical Appeal Management. Key Responsibilities Oversee daily operations of Utilization Management and Clinical Appeal teams, ensuring compliance and efficiency Provide training and professional development for staff, while managing scheduling and staffing levels Conduct performance improvement audits and analyze UM processes to enhance clinical and financial outcomes Required Qualifications Nursing degree: Diploma, ASN or BSN (preferred), with the ability to obtain BSN within 4 years Master's Degree in Nursing or a healthcare-related field preferred Licensed to practice as a Registered Nurse in Massachusetts Minimum of 5 years of inpatient clinical nursing experience and 3 years in utilization review and denials management CCM or related certification preferred within 24 months of hire
A company is looking for a Nurse Manager for Utilization Review and Clinical Appeal Management.
Key Responsibilities
Oversee daily operations of Utilization Management and Clinical Appeal teams, ensuring compliance and efficiency
Provide training and professional development for staff, while managing scheduling and staffing levels
Conduct performance improvement audits and analyze UM processes to enhance clinical and financial outcomes
Required Qualifications
Nursing degree: Diploma, ASN or BSN (preferred), with the ability to obtain BSN within 4 years
Master's Degree in Nursing or a healthcare-related field preferred
Licensed to practice as a Registered Nurse in Massachusetts
Minimum of 5 years of inpatient clinical nursing experience and 3 years in utilization review and denials management
CCM or related certification preferred within 24 months of hire