Massachusetts Licensed Vendor Authorization Nurse

Job Summary

To support vendor-related authorizations, the full-time Massachusetts Licensed Vendor Authorization Nurse will manage processing and managing vendor authorizations, assist with issue resolution, and collaborate with the Utilization Management department and vendors in a remote setting.

Key responsibilities

• Processing and managing vendor authorizations
• Assisting with the identification, escalation, and resolution of vendor authorization issues
• Collaborating with vendors and UM leadership to address authorization processing issues

Required qualifications

• Associate's Degree in Nursing required; Bachelor's Degree preferred
• Massachusetts Registered Nurse (RN) license required
• At least 2-3 years of utilization review experience preferred
• Experience using Interqual or Milliman preferred
• 1-2 years of experience in a payer setting preferred