Remote
The Hartford

Behavioral Health Case Manager  1900156

Description

WHAT CAN YOU TELL ME ABOUT THIS POSITION?

Our team is committed to driving profitability by delivering exceptional customer service and superb claim outcomes! The ideal candidate will be part of a dynamic and talented team of Behavioral Health Disability Claim professionals that are committed to conducting comprehensive evaluations of disability claimants’ functionality via functional assessments. This position is part of a vast team of Behavioral Health Case Managers who are responsible for the review and evaluation of Short Term Disability (STD) and Long Term Disability (LTD) claims. While reviewing cases, our goal is to assess a client’s return to work potential while also improving their functional capabilities. Successful incumbents in this role will perform functional client assessments and interpret clinical information. They will utilize established clinical guidelines/protocols in order to facilitate a client’s ability to leverage their functional capabilities, work experience and educational background to allow for a safe and productive return to work environment. Additional key responsibilities of this role include:

  • Monitors the medical treatment to ensure effective, high-quality and cost-efficient care
  • Conducts comprehensive evaluation of a disability claimant functionality
  • Advises on highly complex claims at multidisciplinary clinical review roundtables to ensure optimal outcomes
  • Determines when claims contain quality of care issues and escalates these through established channels
  • Independently conferences with treating providers and/or other higher level facilities to evaluate clinical symptomology present in claimants
  • Leverages resources such as vocational rehabilitation, risk management unit, physician reviews, home assessments, etc.
  • Manages risk and resources on highly complex behavioral health claims
  • Identifies appropriate return to work options and/or barriers in order to partner with internal resources to ensure a smooth transition back into employability and normal activities
  • Reviews clinical integration systems and determines appropriate referral resources to achieve an optimum level of health
  • Supports the leadership team by demonstrating understanding of customer needs and expectations as well as ensuring performance objectives are met
  • Ensures excellent documentation that clearly and concisely communicates focus of functionality vs. impairment and provides a recommendation of support or non-support of clinical findings
  • Collaborates with Ability Benefits Manager and other key players (Vocational Rehabilitation, Consultants, Medical Nurse Reviewers, etc.) for proactive movement of the claim to resolution
  • Manages Short Term Disability (STD) to Long Term Disability (LTD) transition on all behavioral health claims, coordinating with all resources necessary to ensure a seamless process

Qualifications

  • Minimum of 3 years of post-master’s degree clinical practice experience
  • Master’s Degree required in a behavioral health or mental health discipline
  • License in Behavioral Health Clinical work which may include professional designations in Social Work, Mental Health, Marriage/Family Counseling, etc.
  • Professional licenses in: LMHC, LCSW, LPC or other similar designations are preferred
  • Preference for case management and discharge experience
  • Preference for managed care/utilization review experience
  • Preference for crisis intervention skills
  • Solid technical acumen with Microsoft Office: Word, Excel & PowerPoint
  • Ability to explain complex medical condition
  • Demonstrated aptitude for communicating with attending physicians to identify current workplace limitations or restrictions
  • Accurate clinical assessment and analytical skills
  • Ability to make sound judgments
  • Readily able to accurately document activities
  • Demonstrated desire to learn about the insurance business.

Key Competencies:

  • Negotiation Skills
  • Problem Solving
  • Plan Development
  • Attention to Detail
  • Team-Player
  • Positive Customer-Focused Approach
  • Organizational and Change Management Skills

Equal Opportunity Employer/Females/Minorities/Veterans/Disability/Sexual Orientation/Gender Identity or Expression/Religion/Age

Job Function: Case Management

Primary Location: United States

Schedule: Full-time

Job Level: Individual Contributor

Education Level: Master’s Degree (18 years)

Job Type: Standard

Shift: Day Job

Employee Status: Regular

Overtime Status: Exempt

Travel: No

Remote Worker Option: Yes

The Hartford is an equal employment and affirmative action employer. All qualified applicants will receive consideration without regard to race, color, sex, religion, age, national origin, disability, veteran status, sexual orientation, gender identity or expression, marital status, ancestry or citizenship status, genetic information, pregnancy status or any other characteristic protected by law. The Hartford maintains a drug-free workplace and is committed to building inclusion and leveraging diversity.