Managed Care Specialist

Responsibilities

As a Managed Care Specialist you will provide utilization review information to insurance companies throughout the patient’s stay at Hazelden Betty Ford Foundation (HBFF) and through final payer approval process. Develops relationships with third party payers and other relevant stakeholders to promote HBFF’s clinical services and provide optimal clinical care.

• Create a client/customer focused experience for all clients/referents/customers seeking services through the Hazelden Betty Ford Foundation national system of care
• Function as an advocate for insurance and payer reimbursement for clientele utilizing substance abuse services in the Hazelden Betty Ford Foundation national system of care
• Act as a member of the multidisciplinary team by educating patients, family members, referents and other Hazelden Betty Ford Foundation staff about substance abuse, managed care, and payer medical necessity criteria
• Initiates, develops, and nurtures referent communication in order to promote an individualized relationship ensuring inclusion and participation over the span of Recovery Services
• Provide clinical case management to clients during the treatment process
• Participate in site partnership meetings in order to effectively collaborate with the clinical leaders around managed care needs.
• Effectively managing assigned caseload and tasks, including the ability to help other team members as needed.
• Provide either in-person or virtual observations and trainings on the MCS process to clinical staff at various sites across the nation.
• Support initiatives to improve clinical documentation and patient centered care with the clinical teams across the continuum.

Required

• Bachelor’s Degree
• Minimum 2 years’ experience in Behavioral Health Care field
• Proficiency with technology and computer skills to document in an electronic health record system, attend virtual meetings, and manage outlook emails and calendars.
• Current state licensure in Alcohol and Drug Counseling or like field (i.e. RN, LCSW, LPC, LPCC, LMFT)

Preferred

• Master’s Degree in Behavioral Health Care or related field.
• 5 years’ experience working with Insurance Products and medical necessity criteria.

The Hazelden Betty Ford Foundation is the largest nonprofit addiction recovery organization in the United States. It is also one of the most mission-driven places you will find. The Hazelden Betty Ford Foundation team is passionate about providing hope and ultimately healing. As a living, growing and evolving institution, the Hazelden Betty Ford Foundation is – at our core- a people-powered organization.

Hazelden Betty Ford Foundation is comprised of 1600+ employees, seventeen treatment sites and produces $190 million dollars in annual revenue. This exemplary organization serves nearly 25,000 people annually and is committed to provide hope and healing for those experiencing addiction to alcohol and other drugs.

What makes this organization unique is its total ecosystem approach to prevention, education, research, advocacy and treatment. All of the parts of the organization work together to inform, develop and deliver evidence- based practices that help people reclaim their futures and restore their hope.

Being “a best place to work” is a strategic goal of Hazelden Betty Ford Foundation and it’s a goal that every employee plays an active role in helping to achieve. Our culture is a reflection of how encouraged and energized we each feel about contributing our ideas and performing to our greatest ability. Join us and do meaningful work.

We deeply value our employees. Working at Hazelden Betty Ford Foundation includes a comprehensive benefits package, including:

• Competitive Health, Dental and Vision Plans
• Retirement savings plan with employer match
• Paid time-off
• Tuition reimbursement

The Hazelden Betty Ford Foundation is proud to be an equal opportunity and affirmative action employer. We believe that diversity and inclusion among our colleagues is critical to our success as a force of healing and hope for individuals, families and communities affected by addiction to alcohol and other drugs; and we seek to recruit, develop and retain the most talented people from a diverse candidate pool.

USD $74,598.00 - USD $ /Yr.