About the position
The Behavioral Health Case Manager at The Hartford Financial Services Group plays a crucial role in the evaluation and management of disability claims related to behavioral health. This position is designed for individuals who are passionate about making a difference in the lives of others while also contributing to the profitability and success of the organization. The ideal candidate will join a dynamic team of Behavioral Health Disability Claim professionals dedicated to conducting comprehensive evaluations of disability claimants' functionality through functional assessments. The primary focus of this role is to assess a client's potential for returning to work while enhancing their functional capabilities. As part of a vast team of Behavioral Health Case Managers, the responsibilities include reviewing and evaluating Short-Term Disability (STD) and Long-Term Disability (LTD) claims. The successful candidate will perform functional client assessments, interpret clinical information, and utilize established clinical guidelines and protocols to facilitate clients in leveraging their functional capabilities, work experience, and educational background. This role is integral in ensuring a safe and productive return to work environment for clients, thereby contributing to their overall well-being and recovery. The Behavioral Health Case Manager will also be involved in advising on complex claims during multidisciplinary clinical review roundtables, determining quality of care issues, and independently conferencing with treating providers to evaluate clinical symptomology. The position requires a proactive approach in managing risk and resources on complex behavioral health claims, identifying return to work options, and collaborating with various internal resources to ensure a smooth transition back into employability and normal activities. Excellent documentation skills are essential to communicate the focus of functionality versus impairment and to provide recommendations based on clinical findings. Overall, this role is pivotal in supporting the leadership team by understanding customer needs and expectations while ensuring performance objectives are met, ultimately driving exceptional customer service and superb claim outcomes.
Responsibilities
- 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 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.
Requirements
- Minimum of 3 years of clinical practice experience following a clinical master's degree.
- 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, LMFT, LPC or other similar designations are required.
- A license to practice independently is required.
- Preference for case management and discharge experience.
- Preference for managed care/utilization review/insurance experience.
- Preference for crisis intervention skills.
- Solid technical acumen with Microsoft Office: Word, Excel & PowerPoint.
- Ability to assess and 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.
Nice-to-haves
- Experience in crisis intervention.
- Familiarity with managed care and utilization review processes.
Benefits
- Competitive salary range of $71,280 - $106,920 based on experience and performance.
- Short-term or annual bonuses and long-term incentives.
- On-the-spot recognition programs.
- Hybrid or remote work arrangements available.
- Comprehensive health insurance coverage.
- Support for professional development and learning opportunities.
