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.
...personality with superior communication skills and great work ethic. Data entry and strong organizational... ...and offer solutions. Familiarity with home computers and have at least an average working level typing ability. You should be professional and positive...
...Nurses (LPN) for weekend shifts: Up to $40 p/hr & $2,50... ...clients you decide to work with! Clients are... ...Pasco County.* W2* Full-time, Part-time, PRN (Per Diem)*... ...documented healthcare/home health experience preferred... ...* Evening shift* Night shift* Overnight shift...
...Position responsibilities: The primary duty of the CDL Class A Driver entails the safe and professional operation of a commercial motor vehicle, company equipment, and the courteous delivery of products to our valued customers The CDL Class A Driver is responsible...
...Resumen del puesto: El PCA es un trabajador no cualificado que puede poseer un certificado de formacin ya sea formal (es decir, Asistente de Enfermera Certificado (CNA) o formacin formal interna; competencia y evaluacin por parte de un RN experimentado, licenciado...
...caregiver groups. Assists with screening, identification, diagnosis, management and treatment of victims of abuse, neglect, and domestic violence and of mental health and/or substance abuse problems in patients and family members. ~ Completes a full assessment based...