Utilization Review Clinician, Full time, Day
About The Position
As a Utilization Review Clinician for TaraVista in Devens, Massachusetts, you�ll bring your experience and knowledge where your voice matters. A Utilization Review Clinician is an integral part of our multidisciplinary team. You will be an active participant in the health care team. You are responsible for pre-certification, concurrent and discharge reviews, appeals and denials, and the compliance of contracted quality measures identified by managed care organizations. You will serve as liaison between the hospital and outside payor sources in accordance with the mission and core principals of TaraVista Behavioral Health Center.
Requirements
- Master's level clinician or RN
- Previous utilization management, preferably in an inpatient psychiatric setting
- License eligible (LMHC or LICSW preferred) or RN
- Possess sufficient knowledge regarding clinical treatment of psychiatric patients, the mental health care delivery system, and the managed care environment
- Display excellent communication skills and an ability to integrate clinical and financial information in the context of an overall utilization management program
- Requires the ability to work in a multidisciplinary, fast paced environment with a demonstrated sense of autonomy and professionalism
Responsibilities
- Pre-certification, concurrent and discharge reviews
- Appeals and denials
- Compliance of contracted quality measures identified by managed care organizations
- Serve as liaison between the hospital and outside payor sources
Benefits
- Medical
- Dental
- 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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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
