This job was posted by https://www.vermontjoblink.com : For more
information, please see: https://www.vermontjoblink.com/jobs/1256991
Overview
Make a difference and work with a diverse team of professionals as a
Utilization Review Clinician at the Department of Vermont Health Access
(DVHA)! DVHA\'s Clinical Integrity Unit (CIU) is seeking a Utilization
Review Clinician who will be responsible for ensuring that Vermont
Medicaid members are receiving clinical services that are medically
necessary and at the appropriate level of care.
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Have the work/life balance you need with a Monday-Friday schedule and a
supportive hybrid work environment requiring minimal travel. Eleven paid
state holidays, in addition to a robust benefits package.
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The Utilization Review Clinician position works within the DVHA Clinical
Services Team (CST), which is a team of mental health clinicians,
nurses, pharmacists, dentists, physicians, and administrative
assistants. This position does not involve direct service or require
travel.
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The Utilization Review Clinician has the following responsibilities:\
Work to ensure that Vermont Medicaid members are receiving clinical
services that are medically necessary and at the appropriate level of
care.\
Performing utilization review for inpatient psychiatric hospitalization
and other mental health services. Utilization review is done in
accordance with accepted department criteria and Medicaid Rule.\
Collaborate with providers, facilities and various departments within
the Agency of Human Services to guarantee that members are receiving
services that are both appropriate and of high quality.\
Provides opportunities to participate in additional projects and
clinical initiatives in which the Clinician can utilize their clinical
skills and knowledge more broadly.
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Mission:\
The Department of Vermont Health Access (DVHA)\'s mission is to improve
Vermonters\' health and well-being by providing access to high-quality,
cost-effective health care. We have identified three priorities that
support our mission: Advancing value-based payments, modernizing
information technology infrastructure, and operational performance
improvement. Our department commits to executing our responsibilities
and priorities while adhering to three core values: Transparency,
Integrity and Service.
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Diversity, Equity, and Inclusion:\
As part of our values of transparency, integrity, and service, we are
committed to supporting diversity, equity, inclusion, and accessibility
as part of our person-centered culture. We actively celebrate our
colleagues\' and future colleagues\' different abilities, racial
identity, sexual orientation, ethnicity, age, and gender. Everyone is
welcome and supported here.
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Our State:\
Vermont is a \"small but mighty\" state. We are ranked as one of the top
10 states to raise a family in 2022. We are nationwide leaders for
progressive social and educational policies. We are in Northern New
England, 1.5 hours from Montreal and 3.5 hours from Boston. We have
beautiful Lake Champlain, the Green Mountains, and year-round outdoor
activities.\
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Telework:\
The Department of Vermont Health Access (DVHA) supports a hybrid work
environment. Upon hire, employees work with their supervisor to create a
schedule that aligns with the business needs of the unit. We believe a
hybrid work environment promotes autonomy and allows for increased
flexibility and greater work/life balance.
Environmental Factors
Duties are performed largely in a standard office setting, but private
means of transportation should be available for required travel outside
of the office. Challenges occur on a regular basis involving obtaining
appropriate services for discharge. Duties involve need for effective
working relationships with a number of health care professionals.
