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Behavioral Utilization Review Jobs in Massachusetts

MiraVista

Utilization Review Clinician

Holyoke, MA · On-site

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 ...

Lifepoint Health

Specialist, Utilization Review

Holyoke, MA · On-site

$33.22 - $44.85/hr

At Valley Springs Behavioral Hospital, we are committed to empowering and supporting a diverse and ... Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued ...

Lifepoint Health

Specialist, Utilization Review

Holyoke, MA · On-site

$33.22 - $44.85/hr

At Valley Springs Behavioral Hospital, we are committed to empowering and supporting a diverse and ... Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued ...

Acadia Healthcare

Utilization Specialist

Haverhill, MA · On-site

Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Associate's, Bachelor's, or Master's degree in Social Work, Behavioral or Mental Health, Nursing ...

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Behavioral Utilization Review information

What is the difference between Behavioral Utilization Review vs Behavioral Case Manager?

AspectBehavioral Utilization ReviewBehavioral Case Manager
CredentialsLicensed mental health professionals, certifications varyLicensed clinical social workers, counselors, or therapists
Work EnvironmentReview settings, insurance companies, healthcare facilitiesDirect patient interaction, hospitals, outpatient clinics
Employer & IndustryInsurance companies, healthcare organizationsHospitals, mental health agencies, managed care
Primary FocusAssessing medical necessity, reviewing treatment plansCoordinating care, supporting treatment adherence

Behavioral Utilization Review primarily involves evaluating the necessity of mental health services through review processes, while Behavioral Case Managers focus on coordinating patient care and supporting treatment plans. Both roles require mental health credentials but differ in daily tasks and work settings.

How to become a behavioral utilization review?

To become a behavioral utilization review specialist, candidates typically need a bachelor's degree in psychology, social work, nursing, or a related field. Relevant experience in mental health or healthcare settings, along with knowledge of insurance policies and utilization review processes, is important; some roles may require certification such as the Certified Professional in Utilization Review (CPUR).

Is behavioral utilization review a stressful job?

Behavioral utilization review can be stressful due to the need to evaluate complex mental health cases, meet strict deadlines, and handle sensitive patient information. The role often requires strong attention to detail, critical thinking, and emotional resilience, which can contribute to job-related stress.

What are popular job titles related to Behavioral Utilization Review jobs in Massachusetts?

For Behavioral Utilization Review jobs in Massachusetts, the most frequently searched job titles are:

What job categories do people searching Behavioral Utilization Review jobs in Massachusetts look for?

The top searched job categories for Behavioral Utilization Review jobs in Massachusetts are:

What cities in Massachusetts are hiring for Behavioral Utilization Review jobs?

Cities in Massachusetts with the most Behavioral Utilization Review job openings:

Behavioral Utilization Review jobs near you
Infographic showing various Behavioral Utilization Review job openings in Massachusetts as of August 2026, with employment types broken down into 2% Internship, 3% As Needed, 76% Full Time, and 19% Part Time. Highlights an 93% In-person, and 7% Remote job distribution.

Utilization Review Clinician

TaraVista Behavioral Health

Holyoke, MA

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 13 days ago

Job description

Join us as a Utilization Review Clinician!

Schedule: Monday - Friday, 40 hours, onsite 5 days a week.

As a Utilization Review Clinician for MiraVista in Holyoke, Massachusetts, youll 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, youll 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.

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