Remote Utilization Review Rn Jobs in Braintree, MA

General information
Job Posting Title
Clinical Manager Registered Nurse - (Hybrid Remote - Massachusetts)
Date
Monday, July 6, 2026
City
Boston
State
MA
Country
United States
Working time
Full-time
Description & Requirements
Lead a Team. Improve Lives. Shape the Future of Community-Based Care.
Are you an experienced Registered Nurse leader who is passionate about coaching others, improving clinical quality, and making a meaningful impact in your community? Maximus is seeking a Clinical Manager (RN) to lead a team of dedicated nurse assessors supporting the Massachusetts Executive Office of Health and Human Services (EOHHS) Long-Term Services and Supports (LTSS) Program.
In this leadership role, you'll mentor and develop a team of registered nurses, provide clinical guidance on complex cases, ensure high-quality, person-centered assessments, and help drive exceptional outcomes for individuals receiving community-based services across Massachusetts. Your leadership will directly influence the quality of care delivered to some of the Commonwealth's most vulnerable populations while fostering a culture of clinical excellence, collaboration, and continuous improvement.
This position offers a combination of clinical leadership and field engagement, with approximately 50% travel (averaging three days per week) within an assigned region to support nurses and conduct assessments as needed. Eligible business travel is reimbursed at the current IRS federal mileage rate. The remaining time is focused on coaching staff, reviewing clinical documentation, supporting quality initiatives, partnering with interdisciplinary teams, and helping build a high-performing nursing organization.
If you're looking for an opportunity to lead, mentor, and make a lasting impact beyond direct patient care, we'd love to hear from you.
About the Program:
The Massachusetts Executive Office of Health and Human Services (EOHHS), through the MassHealth Office of Long-Term Services and Supports (LTSS), helps individuals with disabilities and chronic conditions live safely, independently, and with dignity in their communities.
As the Public Assessor Option (PAO), Maximus conducts comprehensive clinical assessments, educates providers, and supports eligibility for Adult Day Health (ADH), Adult Foster Care (AFC), Group Adult Foster Care (GAFC), and Personal Care Attendant (PCA) services throughout the Commonwealth.
Why Nurse Leaders Choose Maximus
Lead and mentor an experienced team of Registered Nurses
Monday-Friday schedule with flexibility to manage your workday
IRS federal mileage reimbursement for eligible business travel
Performance bonus opportunity
Unlimited Time Off (UTO)
Professional development and leadership growth opportunities
Tuition reimbursement and company-paid license renewals
Comprehensive medical, dental, vision, and retirement benefits
Essential Duties and Responsibilities
- Manage clinical and nursing team in the planning, monitoring and execution of all projects within the portfolio.
- Provides direct supervision to a team of direct reports.
- Directly responsible for contract performance including financial, quality, outcomes and client satisfaction.
- Primary point of contact for client and some stakeholders to meet project needs and minimize exposure to risk.
- Contribute to division growth through work on bids and proposals, client communication and related activities.
- Work with Operations and shared services to increase quality, efficiency and cost-effectiveness.
Minimum Requirements
- RN license valid in the state of practice is required
- Bachelor's degree
- 5 year's of related experience or equivalent combination of education and experience required
- Minimum 3 years of experience in project or program management required
- Bachelor's degree in Nursing
- An active, unencumbered Registered Nurse (RN) license in the state of Massachusetts
- Residency in the state of Massachusetts is required
- Minimum of 5 years of clinical nursing experience or equivalent relevant experience
- Minimum 3 years of experience Supervising clinical staff
- Familiarity with Home and Community Based Services waivers (HCBS) and prior experience conducting clinical assessments
- Subject matter expertise in Medicaid LTSS
- Proficiency in Microsoft Office applications
Preferred Requirements
- Master's degree in Nursing
- Proficiency in Adobe applications
- Proficiency in Smartsheet
- Familiarity with the Time to Test (TTT) assessment
- Experience in utilization review or utilization management
- Prior experience working remotely
- Prior experience with data analytics, including preparation of monthly reports and collaboration with state partners
- Minimum understanding of the following:

• Program clinical eligibility requirements for the MA EOHHS LTSS Programs (AFC/GAFC/ADH/ PCA)
• Documentation requirements for Assessment processes, including physician and medical information forms or other TTT Tool documents;
• Caregiver and Surrogate participation in the Assessment process;
• Understanding of the Appeals and pre-Board of Hearing mediation process and how to complete the process, including documentation of activities
• Use of Microsoft Office products (Outlook/ Word) and experience with inputting assessments into an electronic system

Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
- Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
- Minimum 5 Mpbs upload speeds
- Private and secure workspace
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EEO Statement
Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.
Accommodations
Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at applicantaccom@maximus.com.
Minimum Salary
$
90,000.00
Maximum Salary
$
100,000.00