Job Title: Utilization Review Social Worker (LMSW) - Apply by 1/22/2026
Location:
Hartford, CT United States
Position Type:
Full Time
Post Date:
01/14/2026
Expire Date:
02/14/2026
Job Categories:
Social & Human Services
Job Description
Utilization Review Social Worker (LMSW) - Apply by 1/22/2026
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
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 Connecticut, Department of Mental Health and Addiction Services (DMHAS) is currently seeking a dedicated and experienced Utilization Review Social Worker (LMSW) to join our team.
CT 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)
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 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-sufficiency 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.
Qualifications & Requirements MINIMUM QUALIFICATIONS
Possess the credentials of a Licensed Master Social Worker in the state of Connecticut.
