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.
...We are seeking a highly motivated postdoctoral researcher to join the Zero Knowledge Discovery Lab ( to work on problems at the intersection... ...of next-generation learning algorithms to understand human health trajectories through advanced digital twin frameworks, ranging...
...oriented, supporting both brick-and-mortar stores and online sales channels. Role Overview: The Data Entry / Report Specialist will support retail... ..., CA (3 days onsite) Pay: $30hr Start Date: ASAP urgent Schedule: Part-time, 3 days per week...
...Akkodis is seeking a Sr. Scrum Master for a contract position with our Fortune 500 banking client. Rate: $75-$88/hr W2. The rate may be negotiable based on experience, education, geographic location, and other factors. Location: Plano, TX Overview: This...
...Tailored Experiences. Because Excellence is a Lifestyle. Role Description Join the Elite: Senior Level Licensed FL Yacht Broker Opportunity at 365 Yachts Location: Remote Industry: Luxury Yacht Sales Compensation: Industry-leading commission +...
...information visit our website Join us on the journey of two companies' massive electric vehicle project in Bartow County! Summary: Mechanical technician in Utility is responsible for managing various mechanical facilities and their parts including air compressor,...