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.
...subtract multiply and divide in all units of measure using whole numbers Ability to operate clean-up broom, plastic compactor, forklifts, and carts Ability to gain and maintain required forklift certification and license and satisfactory completion of cart driver...
...Job Details: Position: Delivery/Pickupdriver Pay: $600 - $1,200 per week (paid per delivery) Job Type:Independent Contractor/Courier Schedule: Monday through Friday Locations: Saint Louis, MO 63146 Job Summary: Ameriship Parcel Delivery is a medical...
...social, energetic, and community-oriented store associate to join our team at the PokCourt store. As a store associate, you will be assisting and speaking to customers to sell Pokmon singles and sealed products , as well as building and maintaining the PokCourt...
About the Role Are you ready to embark on a dynamic journey to achieve asset management excellence? We are seeking a passionate and driven Analyst or Senior Analyst to join our asset management team. If you thrive in a fast-paced environment and aspire to make a mark...
...Position: Offshore Structural Welder Experience: 2+ years as an Offshore Structural Welder REQUIRED About Allison Integrated Support Solutions for the Gulf of Mexico Allison aggressively provides innovative, integrated, land and marine based support services...