Mount Sinai Careers

Psychiatry Utilization Manager (Social Worker, LCSW)

New York, New York
Allied Health


Job Description

Strength Through Diversity

Ground breaking science. Advancing medicine. Healing made personal.

Department of Social Services (MSH) -  Req Number: 2366152

Job Title: Psychiatry Utilization Manager (Social Worker, LCSW)

 
Roles & Responsibilities:

This Program Specialist will work with two others to do mandated comprehensive clinical reviews of Psychiatry inpatients and Partial Hospital Program [PHP] and Intensive Outpatient Program [IOP] patients. 
These initial, concurrent, and discharge clinical reviews of all managed care patients (Medicare, Medicaid, commercial) are based on the documentation in the medical record and involve consultation with the patient’s attending, social workers, RNs to insure appropriate length of stay, documentation, timely and appropriate discharges and to minimize clinical and administrative denials. Outcomes of these reviews and authorizations are entered daily into Eagle, the Mount Sinai financial system. Ongoing authorization is required for reimbursement. 

This Program Specialists, with the incumbents, participates in twice-weekly inpatient length of stay meetings and meetings as required in the PHP/IOP and participates in efforts to streamline the work for maximum efficiency and to assist in identifying and addressing, as appropriate, any problems likely to lead to potential claim denials in the future. 

 

Requirements:


New York State LCSW required. 
Significant experience with seriously mentally ill patients, preferably including inpatient psychiatry and/or PHP experience
Knowledge of DSM-5.
Previous utilization management experience desirable 
Exceptional collaborative and communication skills 
Exceptional organizational skills for this fast-paced, time-sensitive, detail-oriented position.

 
Strength Through Diversity

The Mount Sinai Health System believes that diversity and inclusion is a driver for excellence. We share a common devotion to delivering exceptional patient care. Yet we’re as diverse as the city we call home- culturally, ethically, in outlook and lifestyle. When you join us, you become a part of Mount Sinai’s unrivaled record of achievement, education and advancement as we revolutionize healthcare delivery together.
 
We work hard to recruit and retain the best people, and to create a welcoming, nurturing work environment where you have the opportunity and support to develop professionally. We share the belief that all employees, regardless of job title or expertise, have an impact on quality patient care. 

Explore more about this opportunity and how you can help us write a new chapter in our story! 

Who We Are

Over 38,000 employees strong, the mission of the Mount Sinai Health System is to provide compassionate patient care with seamless coordination and to advance medicine through unrivaled education, research, and outreach in the many diverse communities we serve.
 
Formed in September 2013, The Mount Sinai Health System combines the excellence of the Icahn School of Medicine at Mount Sinai with seven premier hospitals, including Mount Sinai Beth Israel, Mount Sinai Brooklyn, The Mount Sinai Hospital, Mount Sinai Queens, Mount Sinai West (formerly Mount Sinai Roosevelt), Mount Sinai St. Luke’s, and New York Eye and Ear Infirmary of Mount Sinai.
 
The Mount Sinai Health System is an equal opportunity employer. We promote recognition and respect for individual and cultural differences, and we work to make our employees feel valued and appreciated, whatever their race, gender, background, or sexual orientation. 

EOE Minorities/Women/Disabled/Veterans

 

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