Utilization Review Coordinator PRN Job at The Carolina Center for Behavioral Health, Greer, SC

SWFFdVh0OFZKbnFyRVFHQnVDQ3N4c0lSNHc9PQ==
  • The Carolina Center for Behavioral Health
  • Greer, SC

Job Description

Responsibilities

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.

Qualifications

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.

Job Tags

Relief, Local area, Flexible hours,

Similar Jobs

LexisNexis

Raleigh Legal Solutions Consultant Job at LexisNexis

 ...functionally to deliver on common goals? About our Team LexisNexis Legal & Professional, which serves customers in more than 150...  ...and business customers. About the Role As a Solutions Consultant, you'll provide education and support, build preference, and drive... 

USA Labor Services

Mail Clerks / Mail Machine Operators Job at USA Labor Services

 ...POSTAL CLERK NO EXPERIENCE REQUIRED PAID TRAINING PROVIDED JOB SECURITY The Postal Service is the largest government related agency in terms of employees.The Postal Service currently employs nearly 1 million people and is hiring nationwide.There... 

The Demarco Group

Associate Broker Job at The Demarco Group

 ...Fully Remote- Seeking a licensed Executive Lines remote SR Inside Broker/AE for a top wholesale broker operation in the country. This role is heavier in D&O, crime, fiduciary, EPL but also has cyber and E&O. The Inside Broker/AE is responsible for assisting the... 

Phillipsburg Marble Company

General Manager/ VP of Sales and Operations Job at Phillipsburg Marble Company

 ...About the Role We are seeking an experienced and motivated VP of Sales and Operations / General Manager to oversee sales and operational functions across residential, commercial, and volume-builder projects. This position plays a key role in guiding customers through... 

Mindlance

W2 Oracle HCM Cloud Workforce Scheduling Functional Lead Job at Mindlance

Job Overview We are seeking an experienced Oracle HCM Cloud Workforce Scheduling Functional Lead to lead the design, implementation, and optimization of Workforce Scheduling solutions within Oracle Cloud HCM. The ideal candidate will have strong functional expertise...