Clinical Utilization Review Specialist

6 days ago


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

We are seeking a highly skilled Clinical Utilization Review Specialist to join our team at Hospital for Behavioral Medicine. As a key member of our clinical team, you will be responsible for ensuring that our patients receive the most effective and efficient care possible.

Key Responsibilities
  • Case Management: Develop and implement individualized treatment plans that meet the unique needs of each patient.
  • Utilization Review: Conduct thorough reviews of patient records to ensure that all necessary services are being provided and that patients are receiving the most effective care possible.
  • Communication: Collaborate with patients, families, and healthcare providers to ensure that all parties are informed and engaged in the treatment process.
  • Documentation: Maintain accurate and detailed records of patient interactions, treatment plans, and outcomes.
Requirements
  • Education: Bachelor's degree in nursing or Master's degree in social work, mental health, or related field.
  • Experience: 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: Comprehensive benefits package, including health insurance, 401(k) matching, and paid time off.
  • Professional Development: Opportunities for career growth and professional development.


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