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.
&##128666;Delivery Driver Join the 12th St Catering Team! About the Role At12th St Catering , wedontjust deliver food we deliver experiences. As a Delivery Driver ,yourethefinal touchthat brings our award-winning culinary creations and beautifully...
...Description CERTIFIED SCHOOL NURSES WITH A NJDOE SCHOOL NURSE CERTIFICATE ONLY PLEASE. Empowerment Academy has three campuses, an Elementary... ...home and standing orders of the school physician; Conducting health screenings which include height, weight, blood pressure, hearing...
...with onsite leaders and dispatch. Pay and bonus potential ~ Route and detention pay. ~$5,000 sign-on bonus for experienced drivers. ~ Safety and performance bonuses of up to $600 per quarter. ~ Longevity bonus of up to $750 per quarter. ~ Weekly paychecks....
...IV Pharmacy Technician & Messengers (Government Contract NIH Clinical Center) GLC Government Services is seeking highly qualified Nationally Certified Pharmacy Technicians with inpatient hospital experience for full-time government contract positions at the National...
...Sia is a next-generation, global management consulting group. Founded in 1999, we were born digital. Today our strategy and management... ...strategize and scale leveraging deep expertise and solutions in compliance and risk management, strategic technology partnerships, data...