Inpatient Utilization Review Clinician - Psychiatry

MiraVista Behavioral Health Center; Holyoke (MA); On-site; USD 80,000 - 90,000; Full time

Benefits offered by this job

Medical insurance

Dental/Vision

401(k) match

Disability insurance

Life/AD&D

Paid time off

Flexible Spending Account

Tuition reimbursement

Job summary

As a Utilization Review Clinician at The Vista's Behavioral Health Center in Holyoke, MA, you’ll bring your experience and knowledge where your voice matters. You’ll be an integral part of our multidisciplinary team.

You will handle pre-certification, concurrent and discharge reviews, appeals and denials, and ensure compliance with contracted quality measures identified by managed care organizations. You will also serve as a liaison between the hospital and outside payors.

Qualifications

• Master's level clinician or RN with relevant licensure.
• Experience in utilization management, preferably in inpatient psychiatry.
• Eligible for licensure (LMHC/LICSW) or RN.
• Strong communication and ability to integrate clinical and financial data.

Responsibilities

• Participate as a member of the multidisciplinary health care team.
• Handle pre-certification, concurrent and discharge reviews, appeals and denials, and quality measure compliance.
• Liaise between hospital and outside payor sources per mission and core principles.

Skills

Master's or RN

Utilization management

Psychiatric inpatient exp

Clinical communication

Autonomy in fast-paced env

Education

Licensure eligible (LMHC/LICSW) or RN

Job description

As a Utilization Review Clinician at The Vista's Behavioral Health Center in Holyoke, MA, you’ll bring your experience and knowledge where your voice matters. You’ll be an integral part of our multidisciplinary team.

You will handle pre-certification, concurrent and discharge reviews, appeals and denials, and ensure compliance with contracted quality measures identified by managed care organizations. You will also serve as a liaison between the hospital and outside payors.