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.
...A successful and fast-growing digital media company is hiring a highly organized and self-sufficient Executive & Personal Assistant... ...during downtime, based on your strengths and bandwidth Use Google Suite, Slack, and Airtable to manage communications and project...
...to bring the best possible vision care solutions to eye care professionals. We are currently hiring a Sr. Scientist Active Chemistry to work in our Ramsey, MN facility! The salary for this position is $120,000+ plus annual incentive. Whats in it for you?...
...Join Our Team at BCPS by Behavioral Framework! We are offering flexible hours, a supportive... ...24/7 Telehealth, tuition support, an RBT stipend, and real opportunities for career... ...part time and full time Behavior Technicians at our clinic in Wilmington, NC and we...
...Driver Recruiter Confidential Employer Cincinnati, OH | Hybrid (14 days per month, or as needed for occasional projects) We are seeking an experienced Driver Recruiter to join our team. This role is based in the Cincinnati market with a hybrid schedule, requiring...
...to IDS development policies and procedures Ensure compliance with regulatory requirements including 21 CFR part 11 requirements, BD quality standards, and conveys an expectation of high-quality software Qualifications Require a BS degree in Computer Science...