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.
...network provider subcontracts. Work cooperatively with Hospital discharge planning team to identify patients who would benefit from homebased care and to effectuate efficient and effective discharges in cooperation with patient's physician/mid-level provider. Education...
2+ month interim role, with longer term potential. $25-$27/hr. Compliance Risk Role, Junior Level. Job Description: The team oversees compliance, products (food and drug) all recalls, all product safety initiatives. Involves big data, supporting documentation...
...Job Title: Licensed Physical Therapy Assistant Home-Based Patient Care Specialist Company: Home Health Care, Inc. Schedule: Full-Time or Part-Time with weekend rotation Compensation: $42 - $46 per visit + mileage reimbursement Are you a licensed...
...eligible for up to a $5,000 sign on bonus Performs duties of a clinical and clerical nature. Maintains records and applies knowledge... ...vital signs, (weight, temperature, blood pressure, etc) and documents in the patients medical record Assists provider during exam...
...Inside Sales Representative Fort Myers Office (Hybrid Role) About the Role: The Inside Sales Representative is responsible for providing exceptional customer service and sales support, contributing to the organization's mission of serving Veterans, active-duty service...