Utilization Review Clinician

Job Description

Join Us as a Utilization Review Clinician!

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Schedule: Onsite Monday-Friday, 40 hours/week Holyoke, MA.

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As a Utilization Review Clinician for The Vista's in Holyoke, MA, you’ll bring your experience and knowledge where your voice matters. A Utilization Review Clinician is an integral part of our multidisciplinary team.

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As a Utilization Review Clinician:

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• You will be an active participant in the health care team.
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• 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.
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• You will serve as liaison between the hospital and outside payor sources in accordance with the mission and core principals of The Vista's Behavioral Health Center.
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The Utilization Review Clinician will have the following:

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• Master's level clinician or RN.
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• Previous utilization management, preferably in an inpatient psychiatric setting.
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• License eligible (LMHC or LICSW preferred) or RN.
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• Possess sufficient knowledge regarding clinical treatment of psychiatric patients, the mental health care delivery system, and the managed care environment.
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• Display excellent communication skills and an ability to integrate clinical and financial information in the context of an overall utilization management program.
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• Requires the ability to work in a multidisciplinary, fast paced environment with a demonstrated sense of autonomy and professionalism.
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When you join the growing Vista team as a Utilization Review Clinician, you’ll receive:

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• Medical, Dental, and Vision
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• 401(k) match
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• Employer paid long term disability (LTD)
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• Short term disability (STD)
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• Employer paid life and AD&D Insurance
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• Generous Paid Time Off
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• Flexible Spending Account
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• Tuition Reimbursement
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Pay Range:

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Compensation will be determined based on the candidate's relevant experience.

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$80,000 - $90,000

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The Vista's are 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.