Weekend Utilization Review Jobs in Boston, MA (NOW HIRING)

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Exemption Status:
Exempt
Hiring Range:
$84,011.20 - $176,987.20
Please note that the final offer may vary within this range based on a candidate's experience, skills, qualifications, and internal equity considerations.
Schedule Details:
Holidays - One Major Summer Holiday, Holidays - One Major Winter Holiday, Monday through Friday, Weekends - Every Third Weekend
Scheduled Hours:
8:00am - 4:30pm
Shift:
1 - Day Shift, 8 Hours (United States of America)
Hours:
32
Cost Center:
26000 - 4402 Case Management
Union:
MNA-Milford Regional Medical Center (Massachusetts Nurses Association)
This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process.
Everyone Is a Caregiver
At UMass Memorial Health, everyone is a caregiver - regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day.
In collaboration with other members of the healthcare team, the Case Manager is accountable for coordinating and facilitating the management of care for an assigned group of patients. The goal is to ensure a well-coordinated, individualized care experience through outcome-oriented care within a fiscally responsible framework. This includes early assessment of discharge needs, resource availability, and communication among healthcare team members and families, spanning pre- and post-hospital care.
I. Major Responsibilities:
1. Assessment: Evaluate appropriateness of inpatient admission and assess patient needs to identify high-risk individuals and initiate referrals.
2. Multidisciplinary Practice Guidelines: Participate in the development and monitoring of interdisciplinary guidelines and variance tracking.
3. Collaborative Practice: Work with physicians and healthcare providers to enhance quality of care and utilization management.
4. Discharge Planning: Facilitate timely discharge through early intervention and coordination of services.
5. Data Management: Monitor compliance, collect utilization data, and identify cases for quality and utilization review.
II. Position Qualifications:
License/Certification/Education:
Required:
1. BSN
2. Current Massachusetts RN license
Preferred:
1. CCM certification
Experience/Skills:
Required:
1. 3-5 years of clinical experience with sound judgment and knowledge of current medical care and support systems
2. Previous utilization review, quality assurance, or community experience
3. Strong interpersonal and analytical skills
Preferred:
1. N/A
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
We're striving to make respect a part of everything we do at UMass Memorial Health - for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day.
As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law.
If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at talentacquisition@umassmemorial.org. We will make every effort to respond to your request for disability assistance as soon as possible.