Utilization Review Clinician — Inpatient Psychiatry (MA)

TaraVista Behavioral Health Center; Harvard (MA); On-site; USD 82,000 - 91,000; Full time

Benefits offered by this job

Medical, Dental, and Vision

401(k) match

Employer paid LTD

STD

Employer paid life and AD&D Insurance

Generous Paid Time Off

Flexible Spending Account

Tuition Reimbursement

Job summary

The Vista's in Devens, MA is seeking a Utilization Review Clinician to join a multidisciplinary health care team. You will handle pre-certification, concurrent and discharge reviews and appeals, ensuring compliance with payer requirements and CMS measures while integrating clinical and financial information.

Requirements include a Master's level clinician or RN, plus experience in utilization management in inpatient psychiatry; licensure eligible (LMHC/LICSW or RN); strong communication and

Qualifications

• Master's level clinician or RN required.
• Previous utilization management experience, preferably in inpatient psychiatric setting.
• License eligible (LMHC or LICSW preferred) or RN.
• Knowledge of clinical treatment of psychiatric patients and managed care environment.
• Strong communication skills and ability to integrate clinical and financial information in utilization management.
• Ability to work in a multidisciplinary, fast-paced environment with autonomy and professionalism.

Responsibilities

• Participate actively in the health care team.
• Handle pre-certification, concurrent and discharge reviews, appeals and denials.
• Ensure compliance with contracted quality measures identified by managed care organizations and CMS.
• Serve as liaison between the hospital and outside payor sources.

Skills

Utilization management

Inpatient psychiatry

RN license

LMHC

LICSW

Communication

Autonomy

Education

Master's degree

RN license

Job description

The Vista's in Devens, MA is seeking a Utilization Review Clinician to join a multidisciplinary health care team. You will handle pre-certification, concurrent and discharge reviews and appeals, ensuring compliance with payer requirements and CMS measures while integrating clinical and financial information.

Requirements include a Master's level clinician or RN, plus experience in utilization management in inpatient psychiatry; licensure eligible (LMHC/LICSW or RN); strong communication and