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Utilization Review Clinician

MV Utilization Review
Full-time
On-site
Holyoke, Massachusetts, United States
Overview Career Opportunities with MiraVista Behavioral Health Center
Current job opportunities are posted here as they become available.
This is a hybrid position. 2 days remote, 3 days in Auburn, MA.
Responsibilities You will be an active participant in the health care team.
You will be responsible for pre-certification, concurrent and discharge reviews, appeals and denials, and the compliance of contracted quality measures identified by managed care organizations and CMS.
You will serve as liaison between the hospital and outside payor sources in accordance with the mission and core principals of The Vista\'s.
Qualifications Master\'s level clinician or RN.
Previous utilization management experience, 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.
Benefits 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
The Vista\'s 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.

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