Utilization Review Nurse Supervisor

Job Location(s) US-MA-Wakefield
Job ID


Cannon Cochran Management Services, Inc. (CCMSI) is a leading Third Party Administrator in self-insurance services headquartered in Danville, IL.  We are guided by core values including integrity, insisting on excellence and being passionately focused on customer service.  Those values, coupled with our Employee Stock Ownership Plan (ESOP), engage ownership with our employees and offers top of the line customer service for both our internal and external clients. 


This is a perfect opportunity to work in a growing, dynamic work environment.  CCMSI’s emphasis is on customer service and you will be expected to set and achieve performance goals in a challenging and growing team environment. 


The Utilization Review Nurse Supervisor is responsible for comprehensive case management of assigned case files, acting as a resource for all involved parties.  Oversees the MA Utilization Review Program under 452 CMR 6.00 et seq to ensure that all aspects of the regulation are met and that outstanding customer service is rendered.


  • Maintains the file in accordance with CCMSI’s claims handling guidelines and incorporates the essential activities of case management as defined by CCM Certification guidelines (assessment, planning, implementation, coordination, monitoring, evaluation) throughout the medical case management process on each file.
  • Ensure that appropriate and timely communication on UR determinations are made to injured workers, providers, insurers and attorneys.
  • Supervise staff to ensure that they meet the regulatory requirements under 452 CMR 6.00 et seq.
  • Work directly with the Medical Director in regards to the Quality Management program.
  • Hire, educate and train all new employees on the utilization review process.
  • Perform the credential process in conjunction with the Medical Director. 
  • Attend the Quality Management Committee meetings with the Medical director for maintaining the QM of the UR department at comp mc, inc.
  • Attend mandatory DIA meetings.
  • Supports and fosters a team building environment for all internal and external customers, assuring that their needs are met in a timely and efficient manner.


To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.


Ability to lead/supervise staff.  Thorough understanding of medical terminology, technology and procedures is a must.  Ability to oversee the MA Utilization Review Program under 452 CMR 6.00 et seq to ensure that all aspects of the regulation are met and that outstanding customer service is rendered.  General knowledge of workers’ compensation, medical care, levels of medical care and 452 CMR 6.00 et seq are required. 


Discretion and confidentiality is a must. Knowledge of case management philosophy, process, outcomes and goals as well as assessment criteria, best practice guidelines and protocols. Strong decision making and organizational skills along with attention to detail, planning and documentation is a must.


Reliable, predictable attendance within client service hours for the performance of this position.


Responsive to internal and external client needs.


Ability to clearly communicate verbally and/or in writing both internally and externally.


Education and/or Experience                                                                    


Licensed RN with a current unrestricted license to practice medicine/nursing in MA


2-3 years experience with orthopedic, rehabilitation, neurological, medical/surgical or occupational health preferred.


Computer Skills            


Proficient with Microsoft Office programs. 


Certificates, Licenses, Registrations


Licensed RN.


Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.



Object Handling Categories

Work requires the ability to lift/carry objects routinely as follows:


Light Lifting: No lifting of objects weighing more than 15 pounds on a regular basis.




Responsible for upholding the CCMSI Core Values & Principles which include: performing with integrity; passionately focus on client service; embracing a client-centered vision; maintaining contagious enthusiasm for our clients; searching for the best ideas; looking upon change as an opportunity; insisting upon excellence; creating an atmosphere of excitement, informality and trust; focusing on the situation, issue, or behavior, not the person; maintaining the self-confidence and self-esteem of others; maintaining constructive relationships; taking the initiative to make things better; and leading by example.


CCMSI is an Affirmative Action / Equal Employment Opportunity employer offering an excellent benefit package including Medical, Dental, Prescription Drug, Vision, Flexible Spending, Life, ESOP and 401K. 





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