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 right place. While we appreciate any ER or CCU experience, we are also looking to train a Rockstar tech in the skills required to save lives! If you've got... ...and benefits for your specific location during the process. For positions based in Colorado, Ethos provides eligible...
...ESS Companies Inc. is looking for a motivated, data-driven, and results-oriented, Senior Financial Analyst. The successful candidate will have strong financial modeling and analytical skills and will support leaders with data-driven financial insight, supporting strategic...
...CDL-A Yard Driver Home Daily (Night Shift Pueblo, CO) Now hiring experienced CDL-A drivers for a yard/hostler position at a major retail distribution... ...-trailer experience required APPLY NOW: Online Application Form - Class A Jobs 411 TEXT Melissa: (***) ***-****...
...CEC Entertainment is seeking a Paralegal with strong general corporate background , to support our Corporate Legal department, consisting of one attorney, at our Irving, Texas Corporate Support Center. Essential Functions of the Position : GENERAL Report...
...nostalgia, and building lasting connections to their fandoms. About the Role We are looking for a data-driven Performance Marketing Manager to lead paid media strategy and website performance for our DTC business. This role covers both paid acquisition and...