Utilization Review Clinician

About the role

A Utilization Review Clinician for MiraVista in Holyoke, Massachusetts, you'll bring your experience and knowledge where your voice matters. 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.

Responsibilities

• Pre-certification, concurrent and discharge reviews
• Appeals and denials
• Compliance of contracted quality measures
• Serve as liaison between the hospital and outside payor sources
• Work in a multidisciplinary, fast-paced environment
• Integrate clinical and financial information in the context of an overall utilization management program

Requirements

• Master's level clinician or RN
• License eligible (LMHC or LICSW preferred) or RN
• Sufficient knowledge regarding clinical treatment of psychiatric patients, the mental health care delivery system, and the managed care environment
• Excellent communication skills
• Demonstrated sense of autonomy and professionalism

Qualifications

• Master's level clinician or RN
• License eligible (LMHC or LICSW preferred) or RN
• Sufficient knowledge regarding clinical treatment of psychiatric patients, the mental health care delivery system, and the managed care environment
• Excellent communication skills
• Demonstrated sense of autonomy and professionalism

Skills

• Knowledge of clinical treatment of psychiatric patients
• Understanding of the mental health care delivery system
• Experience with managed care environments
• Strong communication skills
• Ability to work in a multidisciplinary, fast-paced environment

Benefits

• Medical, Dental, and Vision insurance
• 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

\$80,000 - \$90,000

Schedule

Monday - Friday, 40 hours onsite