Utilization Review Clinician

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

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

401(k) match

Long-term Disability

Short-term Disability

Life and AD&D Insurance

Paid Time Off

Flexible Spending Account

Tuition Reimbursement

Job summary

MiraVista Behavioral Health Center in Holyoke, Massachusetts seeks an Utilization Review Clinician to join a multidisciplinary team. You will manage pre-certification, concurrent and discharge reviews, and appeals, ensuring compliance with quality measures and coordinating with payors.

A Master’s level clinician or RN is required, with licensure eligibility for LMHC/LICSW preferred or RN. You will work in a hospital setting, communicating complex clinical and financial information within a

Qualifications

• Master’s level clinician or RN.
• License eligible (LMHC or LICSW preferred) or RN.
• Knowledge of psychiatric treatment and managed care environment.
• Excellent communication and ability to integrate clinical and financial information.

Responsibilities

• Handle pre-certification, concurrent and discharge reviews, appeals and denials.
• Ensure compliance with contracted quality measures identified by managed care organizations.
• Act as liaison between hospital and payor sources.
• Participate in a multidisciplinary, fast-paced utilization management program.

Skills

Strong communication

Multidisciplinary teamwork

Utilization management

Education

Master’s degree in clinical field

RN license

LMHC or LICSW eligibility preferred

Job description

Utilization Review Clinician Join us as a Utilization Review Clinician!

Schedule: Monday - Friday, 40 hours, onsite 5 days a week. 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. The Utilization

Review Clinician will have the following: 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. When you join the growing MiraVista team

as a Utilization Review Clinician, you?ll receive: 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 Pay Range

Compensation will be determined based on the candidate's relevant

experience. $80,000 - $90,000 MiraVista is an equal opportunity

employer, and all qualified applicants will receive consideration for

employment without regard to race, color, religion, age, sex, national

origin, disability status, genetics, protected veteran status, sexual

orientation, gender identity or expression, or any other characteristic

protected by federal, state or local laws.