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Utilization Review Social Worker (LMSW)

Office/On-site

Recruitment # 260109-0964FP-001

Location Hartford, CT

Date Opened 1/14/2026 12:00:00 AM

Salary $78,480 - $106,374/year (*New State employees start at minimum)

Job Type Open to the Public

Close Date 1/22/2026 11:59:00 PM

Go Back Apply View Benefits (https://www.jobapscloud.com/CT/jobs/?b=Benefits)

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+ Introduction

Do you want to utilize your skills and make a difference? Are you ready to take the next step in your career? If so, please read on to learn more about this exciting opportunity!

The State of Connecticu t (https://portal.ct.gov/) , Department of Mental Health and Addiction Services ( DMHAS (https://portal.ct.gov/DMHAS/About-DMHAS/Agency/About-DMHAS) ) is currently seeking a dedicated and experienced Utilization Review Social Worker (LMSW (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=0964FP&R1=&R3=) ) to join our team.

C T Valley Hospital’s Utilization Review Department at the Hartford Blue Hills Campus is seeking a Licensed Master Social Worker to perform vital work within our Addiction Services Division (ASD). This position is accountable for a full range of duties involving the assessment and review of health care delivery systems or medical cost containment activities and programs related to agency efforts to promote cost effective quality of care of cost containment in accordance with various federal and/or state statutes, regulations and guidelines.

POSITION HIGHLIGHTS:

+ Facility: Connecticut Valley Hospital (CVH (https://portal.ct.gov/dmhas/cvh/agency-files/cvh---home-page) )

+ Division: Addiction Services Division (ASD)

+ Unit: Utilization Review Department

+ Location: Hartford Blue Hills Campus - Hartford, CT

+ Schedule: Full -time, 40 hours per week, Monday - Friday, 8:00am - 4:30pm

+ PCN: 136234

WHAT WE CAN OFFER YOU

+ Visit our new State Employee Benefits Overview (https://www.jobapscloud.com/CT/jobs/?b=Benefits) page!

+ Professional growth and development opportunities.

+ A healthy work/life balance to all employees

DISCOVER THE OPPORTUNITY TO:

+ Engage in a rewarding career;

+ Showcase your talents in a meaningful role;

+ Thrive in an exciting environment;

+ Provide support to a division that is passionate about the work we do;

+ Work together in a collaborative team environment.

The Role:

Utilization Review plays a critical role in a state inpatient psychiatric facility, serving as a linchpin between clinical care, regulatory compliance, financial sustainability, and public health outcomes. In this role, you will be performing Medicare/Medicaid billing audits surrounding billable services in the information system. This work is critical to necessary revenue generation and ensuring compliance with Medicare, Medicaid, and The Joint Commission standards and HIPAA regulations.

Job duties include but are not limited to:

+ Assess regulatory compliance and conduct case reviews for quality & appropriate care to ensure proper documentation, service collection, and billing.

+ Participate in quality improvement activities to evaluate and enhance health care processes, standards of care, and documentation.

+ Audit medical records for compliance with Medicare & Medicaid regulations, Joint Commission standards, and hospital documentation requirements.

+ Assist the agency in gathering insurance and entitlement data, healthcare eligibility, and required prior authorizations.

+ Follow up on denied claims.

+ Monitor data quality and missing data in hospital records and in DMHAS electronic information systems; designs & implement strategies to remedy deficiencies.

+ Train and support clinical staff at all sites on computer applications, for which they are authorized, including Electronic Medical Records.

+ Develop and modify training materials and training curricula related to documentation standards and to electronic client information systems.

+ Demonstrate ability to summarize and analyze data, identify trends, and prepare statistical reports used for quality management and evaluating compliance with Agency and Hospital policies and procedures, and State and Federal regulations including but not limited to critical and adverse incidents, services, billing, and other performance indicators.

MORE ABOUT US:

DMHAS is a health care agency whose mission is to promote the overall health and wellness of persons with behavioral health needs through an integrated network of holistic, comprehensive, effective, and efficient services and supports that foster dignity, respect, and self-s ufficiency in those we serve.

CVH's vision and mission is to promote recovery through collaborative, compassionate, and culturally competent treatment in a safe, healthy, and caring environment. We provide trauma informed gender responsive treatment that empowers individuals to manage recovery, improve quality of life and return to the community.

Please note:

A comprehensive medical examination, including a drug screening, will be required of all applicants upon a conditional offer of employment.

All state employees must adhere to Connecticut’s Policy for a Drug Free Workplace (https://portal.ct.gov/das/-/media/das/statewide-hr/a---z-listing-task-pdfs/drug-free-workplace-policy--february-2016.pdf) .

Selection Plan

FOR ASSISTANCE IN APPLYING:

Check out our Applicant Tips on How to Apply! Need more resources? Visit our Applicant Toolkit (https://jobapscloud.com/CT/jobs/?b=KIT) for additional support throughout the recruitment process.

BEFORE YOU APPLY:

+ Meet Minimum Qualifications: Ensure you meet the Minimum Qualifications listed on the job opening by the job closing date. You must specify your qualifications on your application. The minimum experience and training requirements listed must be met by the close date on the job opening, unless otherwise specified.

+ Educational Credits: List your earned credits and degrees from accredited institutions accurately on your application. To receive educational credits towards qualification, the institution must be accredited. If the institution of higher learning is located outside of the U.S., you are responsible for providing documentation from a recognized USA accrediting service which specializes in determining foreign education equivalencies to the contact listed below by the closing date listed on the job posting.

+ Resume Policy: Per Public Act 21-69 (https://www.cga.ct.gov/2021/act/pa/pdf/2021PA-00069-R00SB-00056-PA.pdf) , resumes are not accepted during the initial application process. As the recruitment process progresses, candidates may be required to submit additional documentation to support their qualification(s) for this position. This documentation may include: a cover letter, resume, transcripts, diplomas, performance reviews, attendance records, supervisory references, licensure, etc., at the request and discretion of the hiring agency.

+ Preferred Shift/Location: Select all location(s) and shift(s) you are willing to work on your application. Failure to do so may result in not being considered for vacancies in that specific location or shift.

+ Timely Submission: All application materials must be received by the job posting deadline. You will be unable to make revisions once you officially submit your application to the State. Late submissions are rarely accepted, with exceptions only for documented events that incapacitate individuals during the entire duration of the job posting. Request exceptions by emailing [email protected].

+ Salary Calculations: For current state employees, salary calculations are not necessarily comparable from one of the three branches of state government (i.e., Executive, Legislative, Judicial) to the other.

+ Note: The only way to apply to this posting is via the ‘Apply’ or ‘Apply Online’ buttons on the official State of Connecticut Online Employment Center job posting.

AFTER YOU APPLY:

+ Referral Questions: This posting may require completion of additional Referral Questions (RQs), which must be completed by the questionnaire’s expiration date. If requested, RQs can be accessed via an email sent to you after the job close date or by visiting your JobAps Personal Status Board (Certification Questionnaires section).

+ Prepare For An Interview: Interviews are limited to those whose experience and training are most aligned with the role. To prepare, review this helpful Interview Preparation Guide to make the best impression!

+ Stay connected! Log in daily to your JobAps Personal Status Board to track your status and check email (including spam/junk folders) for updates and tasks.

+ The immediate vacancy is listed above, however, applications to this recruitment may be used for future vacancies in this job class.

+ Note: This position will be filled in accordance with contractual language, reemployment, SEBAC, transfer, promotion and merit employment rules. Candidates who are offered and accept a position with the State of Connecticut are bound by the State Code of Ethics for Public Officials and State employees, available at www.ct.gov/ethics.

QUESTIONS? WE’RE HERE TO HELP:

Due to high volume, we are unable to confirm receipt or provide status updates directly. For recruitment updates, please check your Personal Status Board and review our Frequently Asked Questions. If you have additional questions about the recruitment process, reach out to Julie Barker at [email protected] .

Join the State of Connecticut and take your next career step with confidence!

PURPOSE OF JOB CLASS (NATURE OF WORK)

In a state agency facility or hospital this class is accountable for providing clinical social work services to a limited number of agency clients under the guidance of a licensed clinical social worker or other licensed clinical professional.

EXAMPLES OF DUTIES

+ Provides clinical social work services to agency clients initially under close supervision;

+ Works more independently with acquired experience;

+ Participates as a member of a treatment team;

+ Develops treatment plans, prepares discharge summaries and provides individual, group and family therapy, under supervision;

+ Advocates for clients and develops resources to assist clients in meeting identified needs;

+ Completes all required documentation including progress notes and makes clinical observations of behavior of patients and/or clients;

+ Performs a greater number of specific and complex clinical social work duties and maintains a larger caseload as skills are acquired;

+ Performs related duties as required.

KNOWLEDGE, SKILL AND ABILITY

+ Knowledge of

+ social work methodology, casework, group work and community mobilization;

+ family and interpersonal relationship dynamics;

+ values, sanctions, purposes and ethics of professional social work;

+ social, cultural, economic, medical, psychological and legal issues which influence attitudes and behaviors of clients and families;

+ mental illnesses and substance use disorders and approaches to treatment;

+ Skills

+ interpersonal skills;

+ oral and written communication skills;

+ Ability to devise and implement an appropriate client treatment plan.

MINIMUM QUALIFICATIONS

Possess the credentials of a Licensed Master Social Worker in the state of Connecticut.

PREFERRED QUALIFICATIONS

+ Experience with Utilization Review and Management in a healthcare setting.

+ Experience conducting quality audits for compliance with regulations.

+ Experience with State and Federal Behavioral Health standards and regulations, including but not limited to: The Joint Commission (TJC), Centers for Medicare & Medicaid Services (CMS), Department of Public Health (DPH).

+ Experience providing quality assurance, specifically, writing reports, creating tables and graphs, analyzing data and performance improvement protocols.

SPECIAL REQUIREMENTS

+ Incumbents in this class must possess and maintain eligibility for participation in federal health care programs as defined in 42 U.S. § 1320a-7b(f).

+ Incumbents in this class may be required to have knowledge of sign language and communication ability with the deaf and hearing impaired in certain designated positions.

+ Incumbents in this class may be required to have ability in Spanish oral and written communication in certain designated positions.

+ Incumbents in this class may be required to travel.

Conclusion

AN AFFIRMATIVE ACTION/EQUAL OPPORTUNITY EMPLOYER

The State of Connecticut is an equal opportunity/affirmative action employer and strongly encourages the applications of women, minorities, and persons with disabilities.

ACKNOWLEDGEMENT

As defined by Sec. 5-196 of the Connecticut General Statutes, a job class is a position or group of positions that share general characteristics and are categorized under a single title for administrative purposes. As such, a job class is not meant to be all-inclusive of every task and/or responsibility.

Click on a link below to apply for this position:

Fill out the Supplemental Questionnaire and Application NOW using the Internet. Apply Online