TaraVista Behavioral Health Center Logo

TaraVista Behavioral Health Center

Utilization Review Clinician

Reposted 3 Days Ago
Be an Early Applicant
In-Office
Holyoke, MA
80K-90K Annually
Entry level
In-Office
Holyoke, MA
80K-90K Annually
Entry level
Conducts pre-certification, concurrent, discharge, appeal, and denial reviews for behavioral health services. Ensures compliance with managed care quality measures and serves as liaison between the hospital and payers. Integrates clinical and financial information within utilization management programs while collaborating with multidisciplinary teams. Requires a master's-level clinician or RN, relevant licensure eligibility, psychiatric treatment knowledge, managed care experience, strong communication skills, autonomy, and professionalism.
The summary above was generated by AI

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

MiraVista 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.

Similar Jobs

Yesterday
In-Office
80K-90K Annually
Entry level
80K-90K Annually
Entry level
Healthtech
Conducts pre-certification, concurrent, discharge, appeal, and denial reviews for behavioral health services. Ensures compliance with managed care quality measures and serves as liaison between the hospital and payers. Integrates clinical and financial information within utilization management programs while collaborating with multidisciplinary teams. Requires a master's-level clinician or RN, relevant licensure eligibility, psychiatric treatment knowledge, managed care experience, strong communication skills, autonomy, and professionalism.
3 Minutes Ago
Hybrid
Boston, MA, USA
114K-154K Annually
Junior
114K-154K Annually
Junior
Artificial Intelligence • Fintech • Insurance • Marketing Tech • Software • Analytics
Develop and maintain an insurance claims product in an agile environment using React, TypeScript, Node.js, Java, Spring Boot, and AWS. Build user interfaces, RESTful services, microservices, and backend systems; analyze technical problems; and deliver end-to-end coding, testing, debugging, and automated testing. Collaborate on continuous improvement and Scrum practices. Domestic travel up to 10% is required, with telecommuting permitted up to 60%.
Top Skills: AkamaiAmazon Ec2Amazon S3AWSAws LambdaCloud FoundryJavaJavaScriptJIRAMicroservicesNode.jsReactRestScrumSpring BootTypescript
23 Minutes Ago
Easy Apply
Remote or Hybrid
Boston, MA, USA
Easy Apply
136K-190K Annually
Senior level
136K-190K Annually
Senior level
Artificial Intelligence • Cloud • Information Technology • Machine Learning • Software
Serve as the primary technical contact for customers to design scalable observability solutions, perform POCs, troubleshoot complex issues, deliver onsite training, advise on best practices, and relay customer feedback to product engineering to drive platform improvements.
Top Skills: Active DirectoryApacheAPIsBarracudaCloud-NativeContainerizationDell EquallogicDevOpsEmcF5 BigipGroovyHp LefthandHyper-VIisJdbcJmxLinuxLogicmonitorMySQLNetappNetscalerObservabilityPerfmonPostgresPowershellPythonRubySmtpSnmpSQLTomcatVMwareWindowsWmiXen Server

What you need to know about the Boston Tech Scene

Boston is a powerhouse for technology innovation thanks to world-class research universities like MIT and Harvard and a robust pipeline of venture capital investment. Host to the first telephone call and one of the first general-purpose computers ever put into use, Boston is now a hub for biotechnology, robotics and artificial intelligence — though it’s also home to several B2B software giants. So it’s no surprise that the city consistently ranks among the greatest startup ecosystems in the world.

Key Facts About Boston Tech

  • Number of Tech Workers: 269,000; 9.4% of overall workforce (2024 CompTIA survey)
  • Major Tech Employers: Thermo Fisher Scientific, Toast, Klaviyo, HubSpot, DraftKings
  • Key Industries: Artificial intelligence, biotechnology, robotics, software, aerospace
  • Funding Landscape: $15.7 billion in venture capital funding in 2024 (Pitchbook)
  • Notable Investors: Summit Partners, Volition Capital, Bain Capital Ventures, MassVentures, Highland Capital Partners
  • Research Centers and Universities: MIT, Harvard University, Boston College, Tufts University, Boston University, Northeastern University, Smithsonian Astrophysical Observatory, National Bureau of Economic Research, Broad Institute, Lowell Center for Space Science & Technology, National Emerging Infectious Diseases Laboratories

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account