Utilization Review Coordinator PRN Job at The Carolina Center for Behavioral Health, Greer, SC

Rk9scmN2Y3ltdnVGdHVZNFVIMWh3OGV4bGc9PQ==
  • 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

Local area, Flexible hours,

Similar Jobs

JWK Services LLC

Work from Home Entry-Level Consultant (No experience Required) Job at JWK Services LLC

 ...and services to our clients. This will be a work from home position that will call warm leads, set appointments, and meet...  ...one) Benefits *Flexible Schedule - Full time, part time or side hustle *Training and mentorship by our most... 

Regional Utilities

Safety Coordinator Job at Regional Utilities

 ...water and/or sewer service for a large portion of South Walton County. Responsible for developing and maintaining the organizations safety and environmental policies and procedures in compliance with local, state, EPA and OSHA rules and regulations. Plans and implements... 

Wisemen Multimedia, LLC

Nanny Job at Wisemen Multimedia, LLC

 ...Job Summary: We are seeking a reliable, organized Nanny to provide personalized assistance to the family. The Nannys responsibilities...  ...degree. Work Environment: Private home setting. Some travel may be required for errands or family vacations. Reporting... 

Ansible Government Solutions

Radiologist (Physician) Job at Ansible Government Solutions

 ...Overview Ansible Government Solutions, LLC (Ansible) is currently recruiting Radiologist to provide onsite services to eligible beneficiaries of the San Francsico VA Medical Center located at 4150 Clement St. San Francsico, CA 94121. Shift scheduling is generally Mon... 

BMOC Inc

Multi-Site Property Manager Job at BMOC Inc

 ...Job Title: Multi-Site Property Manager Location: Madison, WI Company: BMOC About Us: BMOC is a reputable property management firm specializing in providing exceptional management services to residential and commercial properties in the Madison area. With a commitment...