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Utilization Review Specialist

2 months ago

Worcester, Massachusetts, United States Hospital for Behavioral Medicine Full time
About the Role

We are seeking a highly skilled Utilization Review Coordinator to join our team at Hospital for Behavioral Medicine. As a key member of our healthcare team, you will play a critical role in ensuring that our patients receive the best possible care.

Key Responsibilities
  • Case Management: Review patient treatment plans and advocate for additional services as needed to ensure effective use of resources.
  • Utilization Management: Collaborate with the treatment team to ensure that patients receive the necessary care and services to achieve optimal outcomes.
  • Communication: Maintain ongoing contact with attending physicians, program managers, and other healthcare professionals to ensure seamless communication and coordination of care.
  • Documentation: Maintain accurate and up-to-date documentation of case management activities, including tracking of insurance reviews and statistical reports.
  • Treatment Planning: Review assessment information and provide feedback to the treatment team on continuing certification of days/services.
  • Discharge Planning: Coordinate discharge plans with patients, families, and healthcare providers to ensure a smooth transition to post-acute care.
Requirements
  • Education: Bachelor's degree in nursing or Master's degree in social work, mental health, or a related field.
  • Experience: A minimum of two years of experience in a behavioral healthcare setting or managed care company, with experience in patient assessment, treatment planning, utilization management, and/or case management.
What We Offer
  • Competitive Salary: $62,400 - $93,600 annually.
  • Benefits: 401(k) + matching, health insurance, life insurance, vision insurance, dental insurance, long-term disability insurance, paid time off, paid holidays, and more.
About Us

Hospital for Behavioral Medicine is a leading provider of exceptional therapeutic care, prioritizing patient comfort and safety. We are committed to accessible care and emphasize availability irrespective of one's ability to pay. Join us in providing exceptional care and contributing to the well-being of individuals and families in need.