Utilization Review Social Work Care Manager

3 months ago

Newington CT, United States Hartford HealthCare Full time

Description Job Schedule: Full Time

Standard Hours: 40

Job Shift: Shift 1

Shift Details: Monday - Friday 7a to 4:30p

Work where  every moment matters.

Every day, over 30,000 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. 

Charlotte Hungerford Hospital is a 122-bed, general acute care community hospital located in Torrington, Connecticut, that serves as a regional health care resource for the 100,000 residents of Litchfield County and Northwest Connecticut. CHH offers personalized attention from an expert team of caregivers and physicians that utilize advanced technology and clinical partnerships in a convenient, safe and comfortable patient environment.

Job Summary

Under the Direction of the Inpatient Nurse Director & Social Work Supervisor, the Inpatient Psychiatric Utilization Review Social Worker will work collaboratively with the IP Psychiatry Patient Care Team to assure Utilization Review activities on a 17 bed Adult unit. The Care Manager will liaison with insurance companies and other referral sources; obtain level-of-care authorizations from managed care companies; secure reauthorization for care; and follow up on insurance denials. Requires in-depth knowledge of behavioral health services in order to accurately articulate and advocate for patient’s care requirements and effectively obtain authorizations.

This UR Social Worker will also provide comprehensive clinical social worker services to patients hospitalized for acute psychiatric needs. The IP Patient Care Team is comprised of MD, ARPN, MSN, RN, Social Worker, Recreational Therapist and Patient Care Technicians. The Social Worker will assess and support patients admitted to the unit, provide clinical recommendations to the team, provide individual, family, and group therapy, and assist in discharge planning.

Job Responsibilities

  • Secures insurance authorizations
  • Conducts a comprehensive bio-psychosocial assessment and establishes a care plan, as appropriate.
    • Collaborates with the interdisciplinary Team to assess for appropriate level of care and risk factors; develops and implements care/discharge plan and coordinates consults/referrals to remove barriers and promote optimal clinical and financial outcomes.
    • Utilizes specific therapeutic methods/strategies/interventions in accordance with individualized care plan
    • Monitors progress of interventions and revises plan to meet patient/family needs.
    • Provides education to patient/family with respect to meeting established goals including but not limited to disease prevention, impact of illness and disease progression, advocacy for benefits, health maintenance, and adherence to treatment regimens.
  • Provides direct patient care that may include: individual, group, & family therapy; case management, interdisciplinary collaboration for care transition needs, crisis intervention/safety planning, counseling, and emotional support to patients and families coping with illness, trauma, or end-of-life care, referral and discharge planning.
  • Refers patient to appropriate levels of care and available resources that promote the individualized care plan.
  • Maintains timely patient-centered documentation that reflect the patient and client systems’ pertinent information for assessment, interventions and outcomes in accordance with regulatory licensing requirements and third-party agencies. 
  • Participates in administrative and development activities including team meetings, clinical supervision of staff and staff education.
  • Supports the development of hospital and/or unit-based programming to meet the clinical and strategic needs of the patients and the milieu.

Qualifications

  • Master's degree in Social Work
  • Active LCSW required
  • Two years with behavioral health utilization review

As a Hartford HealthCare entity, Charlotte Hungerford Hospital 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 seven paid holidays
  • Additional voluntary benefits as well as employee discount programs
  • Stress free commute; free parking and no shuttles

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 .

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