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.
...MEP Procurement Engineer Procurement & Supply Chain (Hybrid) A leading national general contractor is confidentially seeking a MEP Procurement Engineer to support complex commercial and industrial construction projects across the U.S. This role blends technical MEP...
...as a quality assurance consultancy, we have expanded our expertise to include autonomous solutions, Agentive AI, XR research, and NVIDIA Omniverse. After spending the past two years maturing our capabilities and developing in-house products, we are now investing in business...
...0076-60077 Wilmette 60091 Winnetka 60093~ Must have a drivers license - Must be willing to and comfortable driving around... ...proposition of our services to new prospects. ~ The creativity and independence to think outside the box and develop innovative strategies for...
...Business, Marketing, Communications, Real Estate, Finance, or related field). Professional, proactive, and able to work both independently and as part of a team. Minimum of 3+ years of experience in marketing, administration, or commercial real estate preferred. Engagement...
...Position Title: Senior Engineer (Full Stack with Test Automation) Location: Remote Duration: Long Term Assignment Note: Only accepting... ..., and scalable automated test execution environments Develop automation scripts using tools and technologies such as...