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.
We are currently looking for our: Facilities Manager This is a full-time management role accountable for supporting the day-to-day facilities operations of the property, including the shopping center and affiliated business units. The role supports the URW...
WHO WE ARE: Headquartered in Southern California, Skechersthe Comfort Technology Companyhas spent over 30 years helping men, women, and kids everywhere look and feel good. Comfort innovation is at the core of everything we do, driving the development of stylish, high...
Responsibilities: Analyze Bot Attacks: Independently analyze and respond to bot attacks in real-time, ensuring minimal disruption to our services. Pattern Analysis: Identify and analyze attack patterns using Akamai, security logs, and other tools. Query data across...
...About the Position The Financial Institutions Group at Warner is growing, and we are seeking an experienced Banking Attorney. Our team has a strong foundation of talented attorneys, and we are looking to add another professional who will contribute to our ongoing growth...
Job Summary Partners with leaders, employees, and multiple stakeholders to strengthen our safety culture and develop policies and processes, specific to a production center (PC) setting, protecting our most important assets: our employees, our customers, our communities...