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

ATC Marietta

Neuro ICU-Registered Nurse (RN) Job at ATC Marietta

 ...patients in a variety of healthcare settings. The Registered Nurse, or RN, is responsible for working with other healthcare professionals...  ...state of practice.* At least two years of experience as a Neuro ICU Registered Nurse.* Certs: ACLS, BCLS, NIH * Background... 

Integrity Quest Consulting

Commercial Real Estate Analyst Job at Integrity Quest Consulting

 ...Commercial Real Estate Associate Our client, a Fort Worth bank is hiring! This is a multi-billion dollar bank with a top-tier approach...  ...an impeccable track record excellent growth, best-in-class analyst development, and a real path for promotion.The bank is looking... 

Russell Tobin

Customer Service Specialist Job at Russell Tobin

 ...with accuracy and efficiency. Provide support for Brokerage Cash Management products, online platforms, and mobile applications....  ...computer proficiency including navigating web platforms and Microsoft Office. Team player with a positive attitude and willingness to... 

Optima Partners

Associate Job at Optima Partners

 ...resource Have familiarity for practical compliance and regulatory matters relating to SEC (e.g., Advisers Act) CFTC / NFA and FINRA (e.g. broker-dealer) rules, and other regulators experience also a plus Have familiarity with various regulatory mock examination... 

Victory Toyota Ford CDJR of Dyersburg

Dealer Trade Driver Job at Victory Toyota Ford CDJR of Dyersburg

 ...Dealer Trade Driver The Dealer Trade Driver drives company vehicles to transport service customers and pick up and deliver vehicles. Most importantly and without exception, the Delivery Driver operates within the legal speed limits and in a safe fashion at all times...