Utilization Review Care Manager (LCSW, LPC, LADC, LMFT, RN) - Behavior

Employer
William Backus Hospital
Location
Meriden
Salary
Competitive
Posted
Jan 21, 2018
Closes
Feb 18, 2018
Industry
Chemical
Employer Type
Direct Employer
Employment Type
Permanent
Hours
Full Time
Excellence, Safety, Caring, Integrity?.What do you value?

Join us at Rushford as we live our values every day. As part of Hartford HealthCare we create a better future for healthcare in Connecticut and beyond. By embodying these values we have become nationally respected for patient care and most trusted for personalized coordinated care. Come be part of something special!

Rushford Center, one of Connecticut's leading providers of addiction and mental health services, is nationally recognized for delivering outstanding prevention, treatment and recovery programs. We offer a wide range of programs including Acute Care and Evaluation, Residential Addiction Treatment, Individual, Group & Family Therapy, Intensive Outpatient programs and Community Support Programs. Through the passion of our specialists, we continue to treat every patient with care, compassion and respect, while providing affordable and accessible services.

JOB SUMMARY

Coordinates the care of clients by coordinating policies regarding client benefits and by implementing managed care guidelines operating within the effective delivery of clinical services.

KEY RESPONSIBILITIES

1. Obtains level-of-care authorizations from managed care companies, when clinically necessary.

2. 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.

3. Ensures client admission, continued stay, and discharge meet the criteria of the program.

4. Communicates with referral sources to determine benefits and pre-certify admissions.

5. Maintains records and prepares statistical reports as assigned. Enters data into CMHC and ABH to ensure correct billing procedures.

6. Assists with process of appeals as directed by the Manager ? Utilization Review.

7. Provides backup coverage for the Assessment Center as necessary.

8. Performs other duties as may be required.

Education

* Degree in Nursing and/or Master's degree in behavioral health related field.

* Valid CT RN license or Licensed/License Eligible LCSW, LPC, LMFT, LADC.

* PR certified within six months of employment

* Accredited certification in chemical dependency nursing or counseling (or is actively pursuing credentialing).

Experience

* 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. SDL2017