Utilization Review Clinician
$80,000–$90,000 year
On-site · Devens, Massachusetts, United States or Holyoke, Massachusetts, United States
Job Summary
Utilization Review Clinician responsible for pre-certification, concurrent and discharge reviews, and handling appeals/denials within a multidisciplinary hospital-based utilization management program. Serves as liaison between the hospital and payor sources, applying knowledge of psychiatric treatment, the mental health care delivery system, and managed care requirements. Requires experience in utilization management (preferably inpatient psychiatric), an ability to work autonomously in a fast-paced environment, and strong written and verbal communication skills. Eligible for licensure or already licensed (LMHC/LISCW preferred or RN). Compensation includes health benefits, a 401(k) match, disability and life insurance, generous PTO, flexible spending, and tuition reimbursement; salary range $80,000–$90,000 depending on experience.
Required Qualifications
- Master's degree in a clinical field or RN licensing
- License eligible LMHC or LICSW preferred or RN
- Experience in utilization management, preferably in an inpatient psychiatric setting
- 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
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