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.
Pride Health is hiring a Entry Level Phlebotomist to support our clients medical facility in Fort Lauderdale FL 33316 . This is a 4-month assignment with the possibility of a contract-to-hire opportunity, and it's a great way to start working with a top-tier healthcare...
...Are you passionate about managing store operations and ensuring quality service? Do you thrive in a fast-paced environment? Become a Shell assistant manager! Join our team at Shell as an Assistant Manager, where you will work closely with the General Manager to oversee...
...Community hospital part of a system looking to bring on Nurse Manager ICU! Bonus Incentives! Summary: Ensures high quality, patient-centered care through oversight of the overall daily function and staffing of the unit/department. Monitors and evaluates the provision...
...We are hiring an Administrative Assistant to join a top consumer goods company in their Bellevue, WA Headquarters. This position will run for 3 months with the potential to extend. ~ Pay Rate: $20/hr Responsibilities: Extend a warm and professional welcome...
...Summary Operator will be responsible for the setup, programming, and operation of our EDM Sinkers. Utilize processes and tools to produce intricate parts and shapes with high-quality finishes within required specifications. Ensure conformance to specifications using...