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.
...products in a collaborative and agile environment.**Education & Experience**+ Bachelor's or master's degree in computer science, Engineering, Bioinformatics, or related field.+ 5+ years of experience in data engineering+ Prefer prior experience working with regulated...
...providing them with the best platform for their needs. As a Data Analyst - Intern, you will be in a central position as you will be... ...Requirements Bachelors degree in statistics, mathematics, computer science, or related field. Proficient in SQL. Proficient in...
...to our customers! Benefits ~ Meal discount ~ Free uniforms ~ Advancement opportunities ~ Health insurance ~ Flexible schedule ~ Paid time off ~401(k) and 401k ~ Dental insurance ~ Vision insurance ~ Life insurance Hiring Teens 16+ years old
...Mediates relationships with other local general and emergency practices to ensure the best patient and client experience. Human Resources... ...on ways to improve the employee experience. Hospital Management Develops a schedule for hosital maintenance; contracts...
...Exciting Weekend Line Cook Opportunity in San Diego! Royalty Staffing is currently seeking experienced line cooks for an exciting opportunity... ...clubs and sport/entertainment venues! There are two different shift options to choose from. Whichever shift you choose, please be...