Care Manager (LCSW, LPC, LMFT) Utilization Review

Work where every moment matters.
 
Every day, over 40,000 Hartford HealthCare colleagues come to work with one thing in common\: Pride in what we do, knowing every moment matters here.  We invite you to become part of Connecticut’s most comprehensive healthcare network as a Utilization Review Care Manager.

Summary

Coordinates the care of clients in collaboration with clinical program staff.  Liaison with insurance companies and other referral sources.  Obtains level-of-care authorizations from managed care companies when clinically necessary. Requires in-depth knowledge of behavioral health services in order to accurately articulate and advocate for patient’s care requirements and effectively obtain authorizations.

•             Ensures that authorizations are current and documented as required. 

•             Obtains level-of-care authorizations from managed care companies when clinically necessary. Requires in-depth knowledge of behavioral health services in order to accurately articulate and advocate for patient’s care requirements and effectively obtain authorizations.

•             Accurately inputs information into Medical Record System to ensure authorizations are complete. Error or omissions here may result in loss of payment.

•             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 business software and other business systems as required.

•             Assists with process of appeals as directed by the Manager – Utilization Review.

Education

Bachelor’s degree with 5 years’ experience in behavioral health setting, Master’s degree preferred with 3 years’ experience in behavioral health setting

Experience

5 years’ experience in behavioral health setting

Documented assessment skills of the biopsychosocial needs of behavioral health clients.

Licensure, Certification, Registration

LPC, LADC, LMFT, LCSW

We take great care of careers

With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth.  Here, you are part of an organization on the cutting edge – helping to bring new technologies, breakthrough treatments and community education to countless men, women and children.  We know that a thriving organization starts with thriving colleagues-- we provide a competitive benefits program designed to ensure work/life balance.  Every moment matters.  And this is your moment