Utilization Review Clinician

MiraVista Behavioral Health Center • Holyoke, MA

3d • Onsite

About The Position

Join us as a Utilization Review Clinician! As a Utilization Review Clinician for MiraVista in Holyoke, Massachusetts, you’ll bring your experience and knowledge where your voice matters. A Utilization Review Clinician is an integral part of our multidisciplinary team. As a Utilization Review Clinician: 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 MiraVista 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
• Excellent communication skills and an ability to integrate clinical and financial information in the context of an overall utilization management program
• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level