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.
Job Title: JDE Mfg Design to Deploy (DTM) Functional Job Location : Ave Fairview OR 97024 (Remote) Onsite Requirements: JD Edward DTD integration experience with PLM/PDM, MES and other Manufacturing or engineering systems Hands on JDE EnterpriseOne manufacturing...
Family living in Palm Beach, Florida with 1 and 3 year old girls is seeking an educated, experienced, professional, active, and engaging rotational full-time nanny. Family has another residence in Southampton, New York, which they travel to at various times throughout the...
...Highly successful neurosurgery practice in San Antonio, Texas is expanding and looking to add a physician assistant to their practice! Join an existing team of renowned surgeons and APPs and enjoy a wonderful work-life balance rarely found in a surgical field. Candidates...
Scheduling Coordinator Home Care Location Sanford, ME : Arcadia New England Home Care is recruiting an experienced home health care scheduler to add to our corporate team. This position will support all office activities, including: Assisting with field staff and patient...
...We are looking for a professional Content Creator & Video Specialist to join our team. In this role, you will be responsible for... ...other visual assets that align with our brand guidelines. Video Production: Plan, shoot, and edit YouTube videos, including scripting,...