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

Bayforce

Oracle Developer Job at Bayforce

 ...We are seeking a highly skilled and experienced Integration Developer/Specialist to join our team. The ideal candidate will have 5-6 years of Oracle Integration Cloud (OIC) experience and a strong background in integrating various enterprise systems. This role requires... 

Legacy Health

Patient Transport Associate Job at Legacy Health

You represent the Legacy mission in all you do. Your strong interpersonal and relationship-building skills inspire your work providing transportation for our patients. In short, you help make life better for others. Legacy Emanuel Medical Center in North Portland...

Tricoast Homes

Homebuilding Staff Accountant Job at Tricoast Homes

 ...Staff Accountant - Homebuilding Tricoast Homes is a premier builder of highly-amenitized and affordable homes in the greater Houston...  ...and quantitative skills accuracy and attention to detail ~ Bachelors degree in accounting or equivalent. CPA is a plus. ~2 to 4... 

United & Empowered Care

Part-time RN Job at United & Empowered Care

This position is a part time position responsible for the primary and emergency medical care for individuals with intellectual disabilities...  ...: 1 year (Preferred)License:* Driver's License and Driving Record required (Preferred)* RN (Preferred)Salary: $21 hr.

DZL Management Company LLC

Accountant Job at DZL Management Company LLC

 ...DZL Management Company, LLC is seeking an experienced accountant to join our accounting team. This person will be responsible for preparing...  ...QUALIFICATION REQUIREMENTS: Experience Required ~ Bachelors degree in finance or accounting. ~3-5 years of hands-on...