Utilization Review Coordinator PRN Job at The Carolina Center for Behavioral Health, Greer, SC

SWFFdVh0OFZKbnFyRVFHQnVDQ3N4c0lSNHc9PQ==
  • The Carolina Center for Behavioral Health
  • Greer, SC

Job Description

Responsibilities

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.

Qualifications

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 Tags

Relief, Local area, Flexible hours,

Similar Jobs

Martin Painting & Coating Co

Junior Estimator Job at Martin Painting & Coating Co

 ...Painting & Coating is seeking a motivated Junior Estimator to support our New Construction...  ...abilities A desire to grow into a full Estimator role Strong communication and...  ...specialty services. We pride ourselves on developing long-term careers and empowering our associates... 

The McAlear Group

Web Project Coordinator Job at The McAlear Group

 ...role. PREFERRED: Experience with project management tools (Jira, Asana, Trello, or similar). Experience with A/B testing, CRO, or marketing automation platforms. The McAlear Group offers a full range of benefits for eligible employee including 401k,... 

Hengrui Pharma

SD/AVP of Biologics Process Development— 恒瑞-全球精英计划 Job at Hengrui Pharma

Strategic & Technical Leadership# # PD# Deep Domain Expertise & Oversight1. Upstream Process...

RMB Environmental Laboratories INC

Sample Receiving and Microbiology Analyst Job at RMB Environmental Laboratories INC

 ...Safety conscience Current technology and trends Express ideas clearly, concisely, and effectively orally and in writing Exercise appropriate judgment in answering questions and releasing information; analyze and project consequences of decision and/or recommendations... 

Cabinetworks Group

Manufacturing Engineer Job at Cabinetworks Group

 ...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...