Find & Apply For Clinical Auditor / Utilization Reviewer Jobs in West Springfield, Massachusetts

Position Summary Rise Behavioral Health Services, LLC is seeking a CBHI Support Clinician to serve as a cross-program clinical resource supporting our IHT and IHBS programs. This hybrid role combines a limited clinical caseload with clinical auditing, staff training, documentation support, referrals and triage, quality improvement, and program coverage. The clinician will provide approximately 15 billable hours per week across IHT and IHBS, with the remaining time dedicated to clinical and administrative program support. Key Responsibilities Maintain active IHT and IHBS cases and provide approximately 15 billable hours per week. Complete assessments, treatment planning, interventions, caregiver support, case management, collateral coordination, and required clinical documentation. Provide temporary clinical coverage and identify or escalate clinical and safety concerns. Conduct chart and documentation audits for compliance with CBHI, MCE, payer, and Rise requirements. Identify documentation deficiencies, support remediation, and monitor recurring quality or compliance trends. Train and coach clinical staff on documentation, clinical workflows, assessments, treatment planning, case management, and

CBHI/MCE

requirements. Support onboarding, targeted retraining, and development of clinical job aids and training resources. Assist with referrals, triage calls, diagnostic screenings, waitlist management, and Timely Access to Care requirements. Support clinical leadership with case reviews, audit preparation, quality-improvement activities, and other cross-program clinical needs. Qualifications Master's degree in Mental Health, Social Work, Counseling, Psychology, Human Services, or a related clinical field. Meets applicable qualifications to provide clinical services within both IHT and IHBS. Experience working with children, adolescents, and families preferred. CBHI or community-based behavioral health experience preferred. Experience with clinical documentation, auditing, quality assurance, training, or staff development preferred. Strong clinical judgment, documentation, treatment planning, risk-assessment, organizational, and communication skills. Bilingual proficiency preferred. Core Competencies Clinical judgment and risk assessment; IHT and IHBS competency; documentation and auditing; staff training and coaching; quality improvement; organization and time management; cross-program collaboration; cultural responsiveness; and adaptability. Rise Behavioral Health Services LLC is an Equal Opportunity Employer, we do not discriminate in employment based on race, color, gender, gender expression, gender identity, gender reassignment, national origin, political affiliation, religious beliefs and practices, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, pregnancy, parental/maternal status, military service, or other protected characteristics recognized by federal, state and local laws.

Job Type:

Full-time Pay:

From $75,000.00 per year

Benefits:

Dental insurance Health insurance Health savings account Life insurance Paid time off Tuition reimbursement Vision insurance

Work Location:

In person