Utilization Review Care Manager - Behavioral Health

Work where every moment matters.

Every day, over 30,000 Hartford HealthCare employees 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.

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 in collaboration with clinical program staff. Liaison with Managed Care and other referral sources. Ensures that authorizations are current and documented as required.
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 Rushford's business software and other business systems as required.
6. Assists with process of appeals as directed by the Manager - Utilization Review.
7. Performs other duties as assigned.

Qualifications:

Qualifications

• Master Degree preferred or Bachelor's Degree with three years experience in a behavioral health system.
• Valid CT RN license or Licensed clinician /license eligible clinician.
• Accredited certification in chemical dependency nursing or counseling (or is actively pursuing credentialing).
• Minimum of three years' experience as a direct service provider in behavioral health organization.
• 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 biopsychosocial needs of behavioral health clients.

As a Hartford HealthCare entity, Rushford provides eligible employees with an extensive benefits package consisting of:

• Medical and dental benefits
• 401(k) plan with employer match
• Generous paid time off with accrual starting on the date of hire, including six paid holidays
• Additional voluntary benefits as well as employee discount programs

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 employees- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment.