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Manager Utilization Management Ambulatory Services

4 weeks ago

Middletown, United States Rushford Full time

**Description**

**Job Schedule**: Full Time

**Standard Hours**: 40

**Job Shift**: Shift 1

**Shift Details**:
**Work where **every moment **matters.**

**Every day, almost 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**

Manages utilization review function supporting behavioral health ambulatory services across the system. Oversees utilization review administrative processes including online and telephonic authorizations, and data entry. Manages utilization management work queues within electronic medical record (EMR) and coexisting reports.

**Responsibilities**:

- Manages the selection, hiring, training and performance review of all staff members under supervision. Identifies needs and provides opportunities for ongoing staff development. Orients all new staff.
- Audits accuracy of authorizations in electronic medical record to ensure proper billing.
- Collaborates with stakeholders to resolve issues impacting authorization process. Establishes priorities and provides leadership in resolving.
- Develops and manages team to achieve goals and objectives for the department according to the organization's strategic goals. Communicates goals to the staff and monitors progress during the year.
- Develop & implement processes to improve effectiveness and productivity of the department.
- Ensures proper staffing and coverage for Utilization Management department.
- Provides training to new hires and provides updates as managed care regulations change. Trains and assists all behavioral health ambulatory staff on managed care requirements.
- Performs other duties as directed by manager.

**Qualifications**
- Master's degree in behavioral health related field
- Ten years' related experience in a managed care environment
- Ten years' experience working within health care management organizations
- Ten years' experience working with medical records systems
- Ten years' supervisory experience
- Five years' experience managing hybrid or remote working staff
- Excellent written and verbal skills
- Licensed eligible in behavioral health related specialty is preferred

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**.

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