To provide quality case management services to all patient populations and their families. To serve as a member of the interdisciplinary team supporting the organization’s treatment program and philosophy and assure the deliverance of quality treatment to patients and their families. To proactively monitor and optimize reimbursement for organization services.
• Maintain appropriate records of the Utilization Review Department.
• Prepare and submit appeals.
• Attends mandatory training.
• Conducts admission reviews and pre-certs.
• Conducts concurrent and extended stay reviews.
• Prepares and submits appeals to third party payors.
• Schedules and conducts treatment team meetings to provide total case management of the patient by reading and discussing written progress notes from charts and communicating any state or local agency legal requirement for case management with the interdisciplinary team.
• Participates in activities which enhance professional growth and development.
• Demonstrates conduct in keeping with CCBH’s ethical standards.
• Complies with facility safety, infection control and security program.
• Supports facility service excellence standards.
Graduate of accredited RN program with current RN license, or a Masters in Counseling/Social Work or related field. Experience in psychiatric nursing preferred; high school, preferably college level reading, writing, and math skills. Excellent telephone, computer, and communication skills. Knowledge of health care service delivery systems and third party reimbursement; understanding of admission and discharge function. Familiar with medical terminology, diagnostic terms and treatment modalities; knowledge of medical record keeping; strong interpersonal, organizational, evaluative, and time management skills; policy interpretation skills. Must be familiar with applicable standards and regulations. Flexible; pays attention to detail; able to comprehend psychiatric evaluations, consults, labs, etc.; responsiveness to deadlines; assertiveness, persistence and persuasiveness; able to work with minimal direction or supervision.
...of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for Wayfair. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is...
...Were currently hiring a Foreman to oversee roofing and construction projects from start to finish. This hands-on role includes supervising contractors and crews, ensuring quality workmanship, and maintaining strong, professional communication with customers on-site....
...communications. Capture dynamic visuals in both studio and real-world industrial/construction environments. Collaborate Partner with... ...Pro, or DaVinci Resolve). Strong knowledge of cameras, lighting, and audio equipment. Professional audio recording and...
...Holders MEP Preconstruction department is currently located in our Atlanta office. Primary Responsibilities Work with project teams to lead and manage MEP preconstruction activities, including estimating, design management, and subcontractor/vendor procurement....
...FUNCTIONAL RESPONSIBILITIES: Prepare capital and expense projects including definition of project and costing. Prepare all engineering prints, Statement of Work and related Request for Quotes (RFQ) and manage contractors through implementation of project. Proactively...