Utilization Review Specialist

1 week 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 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: 401(k) + matching, health insurance, life insurance, vision insurance, dental insurance, long-term disability insurance, paid time off, paid holidays, and cafeteria on site.
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.



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