Utilization Management Director jobs in Massachusetts

A leading acute care hospital located in eastern Massachusetts is now searching for an experienced Nurse Director Utilization Review to join their award-winning healthcare team

This not-for-profit acute care hospital is a respected healthcare facility with a long-standing history of providing a range of quality medical services to the local community. Committed to delivering quality care, this organization offers various healthcare services, including emergency care, surgical procedures, diagnostic imaging, rehabilitation, maternity care, and specialized treatments. The hospital focuses on patient well-being and remains a trusted provider in the region.

Reporting to the Senior VP Clinical Operations, the Nurse Director Utilization Review will provide leadership to the hospital case management, integrated clinical services, discharge planning, and care transitions. Responsibilities include focusing on patient throughput and placement status, chairs the Utilization Review committee, ensures timely and effective communication with stakeholders, takes an active leadership role in daily rounds, offers in-depth knowledge of Medical and Medicaid, ensures regulatory compliance, and has oversight of department budgets. The Nurse Director is supported by one Lead Case Manager and a staff of 30 Staff Case Managers.

What Makes You Awesome:

• Bachelor’s level degree in Nursing BSN
• Registered Nurse RN license in the state of Massachusetts or ability to obtain
• Progressive leadership experience in acute care case management

Located in eastern Massachusetts, this region is known to attract many families and professionals due to its enjoyable climate, diverse communities, and highly rated school systems.

This organization is prepared to offer a competitive compensation package including industry leading benefits and continued growth opportunities.