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.
Dunmore Asphalt, a division of H&K Group, Inc., is looking for the ideal Asphalt Groundperson for both first and second shift. The ideal candidate is safety focused, action oriented, pays attention to detail, and excels at teamwork. Why work for H&K Group...
Hanna Interpreting Services LLC is a language service provider that connects bilingual and multilingual individuals with potential opportunities to serve as a freelance interpreter or translator. Our mission is to bridge the communication gap for those in need through ...
...Job Title Service Sales Representative- Managing around 25 accounts, not having to drive in new business. Location Fremont, CA Hybrid schedule with three days per week in office Compensation Base salary approximately $125,000 plus incentive compensation...
Kate Spade is seeking an Assistant Designer for its outlet division in New York. This role involves supporting the design and development of... ...aesthetics. Candidates should have a bachelor's degree in Fashion Design and 1-2 years of industry experience. Proficiency in...
...engineering technicians, and clients; and completing digital reports daily. Technicians will: Meet with their manager at the office, travel to job sites, perform required tasks, report results to the PM, and either get a new assignment or finish for the day. Work on...