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MMQ RN Reviewer - Telecommute - Hampden, Berskhire or Hampshire, MA

UnitedHealth Group

Springfield, MA
Job Code:
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Job Details

MMQ RN Reviewer - Telecommute - Hampden, Berskhire or Hampshire, MA(Job Number:712163)

There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Can you feel it? Bring that energy to a role that helps us offer a higher level of care than you'll find anywhere else. Put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered. As a Utilization Management Nurse you will be responsible for ensuring proper utilization of our health services. This means you will be tasked with assessing and interpreting member needs and identifying solutions that will help our members live healthier lives. This is an inspiring job at a truly inspired organization. Ready for a new path? Join us and start doing your life's best work. (sm)

As the Onsite Utilization Management Review Nurse, you will review member charts at assigned facilities and ensure the correct level of care is provided. This is an autonomous role that will allow you to work out in the field with the providers.


**Please Note:  If you have already recently applied for a MMQ RN Reviewer role in MA, you do not need to apply to this one as well.  Please only apply to the posting for the location that is the closest to where you reside**
***This is a telecommuter position, but it does require that the individual live in the state of Massachusetts.***


Primary Responsibilities:

  • Interacts with LTSS Nursing Facility providers routinely to arrange site perform site audits
  • Conducts quality Nursing Facility audits
  • Communicates with appropriate parties issues, implications and decisions
  • Responsible for the reporting and analysis of Nursing Facility audits and for the development of plans to support continuous quality improvement


Job Clinical Utilization Managemen
Primary Location US-MA-Springfield
Other Location US-MA-Pittsfield
Organization Government Solutions Sr Mgmt
Schedule Full-time
Number of Openings 9
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UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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