Utilization Review Clinician

TaraVista Behavioral Health

$80K — $90K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Master's level clinician or RN
  • Previous utilization management experience, ideally in inpatient psychiatric settings
  • License eligible (LMHC or LICSW preferred) or RN
  • Knowledge of psychiatric patient treatment and mental health care delivery
  • Strong communication skills to integrate clinical and financial data
  • Ability to work autonomously in a fast-paced multidisciplinary environment

Responsibilities

  • Participate actively in the healthcare team
  • Conduct pre-certification, concurrent, and discharge reviews
  • Handle appeals and denials
  • Ensure compliance with quality measures from managed care organizations
  • Serve as a liaison between the hospital and external payor sources

Benefits

  • Medical, Dental, and Vision coverage
  • 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
Full Job Description
Join us as a Utilization Review Clinician!

Schedule: Monday - Friday, 40 hours onsite.

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

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