Health Underwriting Manager jobs in Charleston, WV

Bachelor’s Degree in a Human Service field required. West Virginia Social Work License preferred. Experience in behavioral health preferred.  Valid driver’s license and vehicle required. Demonstrated knowledge of basic computer skills required.  Must pass a Criminal Background Check and Employment Fitness Determination through WVCARES and a drug screen.  

ESSENTIAL FUNCTIONS: 

1. Perform an initial or reassessment evaluation to determine the needs, strengths, functional level(s), mental status, and/or social history of assigned individuals. 

2. Ensure an ongoing formal and informal process to collect and interpret information about client strengths, needs, resources, and life goals to be used in the development of an individualized treatment strategy. 

3. Assure and facilitate the development of a comprehensive, individualized treatment strategy and ensure regular reviews are conducted based on the client needs. 

4. Perform linkage/referral to all internal and external services and supports. 

5. Advocate on behalf of client to ensure continuity of services, system flexibility, integrated services, proper utilization of facilities and resources, and accessibility to services. 

6. Follow-up with client on a regular and consistent basis to ensure their needs (and goals) are being met and that circumstances and priorities have not changed.

7. Ensure adequate and appropriate crisis response planning procedures are available to the client and assist as necessary in accessing crisis support services and interventions. 

8. Continually evaluate the appropriateness of the treatment strategy and make appropriate modifications, establish new linkages, or engage in other dispositions as necessary.  

9. Provide supportive behavioral health counseling to maintain client progress towards identified goals and to assist in day-to-day management and problem solving as needed. 

10. Coordinate warm hand-offs with other staff to ensure the client is receiving recommended and/or appropriate treatment services.  

11. Submit the required utilization management information to ensure all services are authorized prior to service. Follow-up on authorizations as needed. 

12. Assure quality service for clients by becoming knowledgeable of and adhering to rules, regulations and legal requirements and by documenting services provided in accordance with established standards.

13. Secure information by adhering to HIPAA and 42 CFR Part 2 regulations and Seneca privacy policies and keeping client information confidential.

14. Represent Seneca in a positive manner including maintaining a positive attitude and performing duties in a manner in accordance with Seneca’s Code of Conduct and Ethical Practices. 

15. Other duties as assigned by supervisor. 

Minimum Physical Requirements 

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.  

While performing the duties of this job, the employee is frequently required to sit; use of arm, hand and finger dexterity, including ability to grasp, and visual acuity to use a keyboard. The employee is occasionally required to
stand; walk; reach with hands and arms; climb stairs; balance; bend or crouch; talk and hear; and drive a motor vehicle. The employee must occasionally lift and/or move up to 20 pounds. Specific vision abilities required by the job include close vision and distance vision.  

This job description reflects management's assignment of essential functions; it does not restrict the tasks that may be assigned.