Washburn House
  • Admissions
  • Worcester, MA, USA
  • Full Time


Join our Team: Washburn House is seeking highly skilled, extremely motivated and seasoned professionals to join us from inception. Our new state of the art treatment program was born on the foundation that together we can transform the lives of patients and their families affected by alcoholism and other addictions. From inception, we will provide a clinical care model that is technology driven, patient-focused, and evidenced-based care across the spectrum of addiction and dual-diagnosis treatment. If you adhere to our philosophy that substance use disorders is a chronic brain disorder from which people can and do recover and are seeking full or part time employment we want to hear from you.


Works closely with the members of the Washburn House Admissions Department, with special attention to the administration of utilization review. This position is responsible for the analysis of patient records to determine legitimacy of admission, treatment, and length of stay in the facility. The Utilization Review Coordinator reviews all processes to ensure compliance with government and insurance company reimbursement policies. Furthermore, ongoing analysis of insurance, governmental, and accrediting agency standards to determine criteria concerning admissions, treatment, and length of stay of patients is required for this position.

ESSENTIAL JOB FUNCTIONS include the following.  Other duties may be assigned.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Obtains level-of-care authorizations from managed care companies, when medically and clinically necessary.
  • Collaborates with the payor source and the primary clinician/treatment team and refers clients to appropriate level of care, based on symptomatology and benefit structure.
  • Ensures client admission, continued stay, and discharge meet the criteria of the program.
  • Communicates with referral sources to determine benefits and pre-certify admissions.
  • Maintains records and prepares statistical reports as assigned. Enters data into EMR to ensure correct billing procedures.
  • Assists with process of appeals as directed by the UR Manager Utilization Review.
  • Provides backup coverage for the Assessment Center as necessary.
  • Performs other duties as may be required.


  • Degree in Nursing and/or Master's degree in behavioral health related field.
  • Valid MA RN license or Licensed/License Eligible LICSW, LMHC, LMFT, LADC.
  • Minimum of three years' experience as a direct service provider in both substance abuse and mental health.
  • Demonstrated ability to work collaboratively with a managed care and a clinical team as evidenced by credentials and supervised experience.
  • Documented assessment skills of the bio psychosocial needs of behavioral health clients.
  • Understanding of ASAM Patient Placement Criteria
Washburn House
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