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.
...The Sales Supervisor is responsible for assisting the Store Management staff in maximizing sales, providing an exceptional shopping experience for the customer and managing the store in accordance with the company visual and operational standards. The Sales Supervisor...
...Not open for C2C or referrals. Compensation: $120K - $120 per year For immediate consideration, please email your resume top ****@*****.***. Duties & Responsibilities # Develop and maintain the project schedule; monitor progress, allocate resources...
...phone troubleshooting support to customers May be required to provide after-hours phone troubleshooting support Will be asked to travel extensively, nationwide REQUIRED QUALIFICATIONS: Experience with industrial and commercial electrical systems Knowledge...
...Job description Job Summary: A well-established property management company is seeking an experienced Community Manager to oversee... ...~ Dental insurance ~ Health insurance ~ Life insurance ~ Paid time off ~ Vision insurance Work Location: In person...
...General Manager Construction & Infrastructure Services A long-established construction and infrastructure services organization is seeking a hands-on General Manager to oversee all day-to-day operations, drive performance, and lead the business through its next phase...