Utilization Review Clinician

MiraVista Behavioral Health Center
Holyoke, MA
Category Healthcare
Job Description
Role Overview

Join MiraVista Behavioral Health Center as a Utilization Review Clinician, working Monday - Friday, 40 hours onsite. As a Utilization Review Clinician, you'll be an active participant in the healthcare team, responsible for pre-certification, concurrent and discharge reviews, appeals and denials, and compliance of contracted quality measures. You'll serve as a liaison between the hospital and outside payor sources.

What You Will Do

Pre-certification, concurrent and discharge reviews, appeals and denials, and compliance of contracted quality measures. Liaison between the hospital and outside payor sources.

Why It Might Be a Fit

Master's level clinician or RN with previous utilization management experience, preferably in an inpatient psychiatric setting. Excellent communication skills and ability to integrate clinical and financial information.

Requirements

  • Master's level clinician or RN
  • Previous utilization management experience, preferably in an inpatient psychiatric setting
  • License eligible (LMHC or LICSW preferred) or RN
  • Sufficient knowledge regarding clinical treatment of psychiatric patients, the mental health care delivery system, and the managed care environment
  • Excellent communication skills and ability to integrate clinical and financial information
  • Ability to work in a multidisciplinary, fast paced environment with a demonstrated sense of autonomy and professionalism

Benefits

  • Medical, Dental, and Vision
  • 401(k) match
  • Employer paid long term disability (LTD)
  • Short term disability (STD)
  • Employer paid life and AD&D Insurance
  • Generous Paid Time Off
  • Flexible Spending Account
  • Tuition Reimbursement
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