Top 150 Authorization nurse Jobs in Boston, Ma

Clinical Appeals RN
Optum —Boston, MA
- $28.94 - $51.83 an hour
- Full-time
- Remote
- Nursing
- Microsoft Excel
- RN License
- AD&D insurance
- Employee stock purchase plan
School Nurse Consultant
Acera School —Winchester, MA
- $40 - $60 an hour
- 8 hour shift
- School experience
- RN License
- US work authorization
Registered Nurse, PECAN (Cardiac) Program
Boston Children's Hospital —Boston, MA
- $81,078.40 - $174,584.80 a year
- Full-time
- Nursing
- RN License
- Hospital
Registered Nurse- Genetics
Boston Children's Hospital —Brookline, MA
- $81,078.40 - $174,584.80 a year
- 8 hour shift
- Nursing
- RN License
- Mid-level
Clinical Solutions Delivery Consultant-Boston, Hartford, Vermont
Philips —Boston, MA
- $90,000 - $143,000 a year
- Full-time
- Hospital
- 5 years
- Clinic
- Health savings account
- Employee stock purchase plan
Ambulatory Nurse - MGB Cancer Institute at BWH
The Brigham and Women's Hospital, Inc. —Boston, MA
- $41.71 - $105.65 an hour
- Full-time
- Nursing
- Blood sampling
- Patient monitoring
- Opportunities for advancement
Quick Apply
7d
Sr Utilization Management Nurse RN - Field Position
Optum —Boston, MA
- $72,800 - $130,000 a year
- Full-time
- Nursing
- RN License
- Computer literacy
Registered Nurse - Per Diem
Boston Health Care for the Homeless Program —Boston, MA
- $49 - $55 an hour
- Monday to Friday
- RN License
- Adults
- Mid-level
Quick Apply
Clinical Policy Configuration Specialist
Cohere Health —Boston, MA
- $65,000 - $80,000 a year
- Remote
- Microsoft Word
- Nursing
- Microsoft Excel
- Paid parental leave
- Health savings account
Quick Apply
Registered Nurse - Clinic
Software Technology Inc —Needham, MA
- Monday to Friday
- RN License
- BLS Certification
- Primary Care
Quick Apply
Registered Nurse- Neuro Clinic
Boston Children's Hospital —Boston, MA
- $81,078.40 - $174,584.80 a year
- Full-time
- Nursing
- RN License
- Mid-level
1d
Per Diem AFC Registered Nurse
Boston Senior Home Care —Boston, MA
- From $52.50 an hour
- Part-time
- Hybrid work
- Nursing
- RN License
- Ability to walk for extended periods
Quick Apply
Clinical Audit Response Specialist
Dana-Farber Cancer Institute —Boston, MA
- $110,200 - $122,300 a year
- Full-time
- Nursing
- RN License
- 5 years
Registered Nurse - Chelsea, MA
Software Technology Inc —Chelsea, MA
- Monday to Friday
- RN License
- BLS Certification
- Primary Care
Quick Apply
LPN - 20 hours
ROAD TO RESPONSIBILITY INC —Hingham, MA
- $37 an hour
- Part-time
- Microsoft Word
- Experience working with individuals with disabilities
- Computer literacy
Quick Apply
Registered Nurse Case Manager, RN
South Shore Support Services —Hingham, MA
- $40 an hour
- Part-time
- Microsoft Word
- Background check
- Experience working with individuals with developmental disabilities
- Health insurance
- Dental insurance
Quick Apply
Registered Nurse - Oncology
TalentBurst, Inc. —Boston, MA
- $3,847 - $3,887 a week
- Rotating weekends
- RN License
- BLS Certification
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
9d
Morning Behavioral Health Nurse
Innovive Health —Woburn, MA
- $74,000 - $80,000 a year
- Full-time
- Ability to walk for extended periods
- Mid-level
- Home Health
Quick Apply
Weekend Behavioral Health Nurse
Innovive Health —Boston, MA
- $84,000 a year
- Full-time
- Ability to walk for extended periods
- Mid-level
- Home Health
- Continuing education credits
- Mileage reimbursement
Quick Apply
Morning Behavioral Health Nurse
Innovive Health —Ipswich, MA
- $74,000 - $80,000 a year
- Full-time
- Ability to walk for extended periods
- Mid-level
- Home Health
Quick Apply

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authorization nurse jobs near boston, ma

Clinical Appeals RN

Optum -
Boston, MA

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Job Details

Full-time
$28.94 - $51.83 an hour

Benefits

AD&D insurance
Employee stock purchase plan
Paid holidays
Disability insurance
Health insurance
Dental insurance
401(k)
Tuition reimbursement
Paid time off
Employee assistance program
Vision insurance
Employee discount
Referral program
Pet insurance

Qualifications

Nursing
RN License
Associate's degree
Associate Degree in Nursing
Nursing

Full Job Description

Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come makes an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The Clinical Appeals RN is responsible for attending appeal hearings, defending MassHealth prior authorization decisions, and performing pre-service/prior authorization clinical coverage review of services. Works closely with managers and peers.

If you currently reside in the state of Massachusetts, you'll enjoy the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

Represent MassHealth at appeal hearings
Defend MassHealth prior authorization decisions by utilizing program specific regulations, medical necessity guidelines, standards of care and best practices
Represents the MA MLTSS program in a positive, solution-focused manner that embodies our corporate values: Integrity, Compassion, Relationships, Innovation and Performance
Determine the appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination
Identify solutions to non-standard requests and problems
Participate in regular meetings to collaborate with supporting leadership and team to ensure operational efficiency
Assures performance adheres with established quality standards, evidenced based practice guidelines and departmental benchmarks and workflows
Act as a resource for others; provide explanations and information on difficult issues
Minimum 10% travel within the state of MA

What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
Medical Plan options along with participation in a Health Spending Account or a Health Saving account
Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
401(k) Savings Plan, Employee Stock Purchase Plan
Education Reimbursement
Employee Discounts
Employee Assistance Program
Employee Referral Bonus Program
Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

Associate's degree in Nursing
Unrestricted RN license required in the state of Massachusetts
3+ years of Managed Care and/or clinical experience
Designated workspace and access to install secure high-speed internet via cable or DSL in home
Reside in the state of Massachusetts

Preferred Qualifications:

Prior-Authorization experience
Utilization Management experience
Appeals Experience
Medicare/Medicaid experience preferred
Proficient with Microsoft Office programs, including Word, Excel, PowerPoint
Excellent communications skills, including the ability to write clearly, succinctly and in a manner that appeals to a wide audience
Excellent time management, organizational, and prioritization skills with ability to balance multiple priorities
All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.94 to $51.83 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

#RPO #GREEN

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Refine Your Search

authorization nurse jobs in boston, ma

Clinical Appeals RN

School Nurse Consultant

Registered Nurse, PECAN (Cardiac) Program

Registered Nurse- Genetics

Clinical Solutions Delivery Consultant-Boston, Hartford, Vermont

Ambulatory Nurse - MGB Cancer Institute at BWH

Sr Utilization Management Nurse RN - Field Position

Registered Nurse - Per Diem

Clinical Policy Configuration Specialist

Registered Nurse - Clinic

Registered Nurse- Neuro Clinic

Per Diem AFC Registered Nurse

Clinical Audit Response Specialist

Registered Nurse - Chelsea, MA

LPN - 20 hours

Registered Nurse Case Manager, RN

Registered Nurse - Oncology

Morning Behavioral Health Nurse

Weekend Behavioral Health Nurse

Morning Behavioral Health Nurse

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