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Utilization Review Coordinator: Rn Or Msw

Company

The Carolina Center for Behavioral Health

Address , Greer, 29650
Employment type FULL_TIME
Salary
Expires 2023-09-21
Posted at 8 months ago
Job Description
Responsibilities:
The Carolina Center for Behavioral Health is currently looking for a Utilitization Review Coordinator to join our team of dedicated professionals.

Who We Are
The Carolina Center for Behavioral Health is a 156-bed licensed, private psychiatric facility located on 13 acres in Greer, SC, conveniently close to I-85. Specializing in psychiatric programs and substance use treatment, inpatient programs are offered for adolescents, adults and senior adults. There are also intensive outpatient programs (IOP) and partial hospitalization programs (PHP) for patients with psychiatric and co-occurring psychiatric and substance use disorders. Above all else, we treat every patient with compassion and respect. Using evidence-based treatment approaches and individualized care, we strive to instill hope in our patients, their families and our community.

Who You Are
It’s the opportunity to make a difference that drives you. It's taking the time to really listen to a patient so you can do your best to help. It's the camaraderie among professionals who push you further than you ever thought you could go. You are as equally diligent and attentive during quiet times as you are in a crisis situation. You are a highly empathetic individual with a high level of emotional and social intelligence. Your satisfaction comes from a patient’s noticeable progress or a sincere word of thanks from your patient's family. It's these experiences that solidify your dedication to helping others.

Position Summary:
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. Position to include:
  • Prepare and submit appeals.
  • Conducts concurrent and extended stay reviews.
  • Maintain appropriate records of the Utilization Review Department.
  • 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.
  • Complies with facility safety, infection control and security program.
  • Supports facility service excellence standards.
  • Attends mandatory training
  • Conducts admission reviews and pre-certs.
  • Demonstrates conduct in keeping with CCBH’s ethical standards.
  • Participates in activities which enhance professional growth and development.
Benefit Highlights:
Challenging and rewarding work environment • Career development opportunities • Competitive Compensation
Qualifications:
Graduate of accredited RN program and current RN license, or adequate utilization management experience or a Masters in Counseling/Social Work or related Masters Degree. Experience in psychiatric nursing preferred; high school, preferably college level reading, writing, and math skills. Excellent telephone skills 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.

Physical and Mental Requirements of the Job:
Ability to stop, kneel, crouch, crawl, reach, stand, walk, push, pull, lift, grasp, and be able to perceive the attributes of objects such as size, shape, temperature, and/or texture by touching with skin, particularly that of the fingertips. Ability to express and exchange ideas via spoken word during activities in which they must convey detail or important spoken instructions to others accurately, sometimes quickly and loudly. Hearing to perceive the nature of sound with no less than 40 db loss @ Hz,1000 Hz, and 2000 Hz with or without correction; ability to perceive detailed information through oral communication and to make fine discriminations in sound. Perform repetitive motions with wrists, hands and fingers.
Individual must be able to exert up to 100 pounds of force and be able to lift, carry, push, pull or otherwise move objects. Work requires a minimum standard of visual acuity with or without correction that will enable people in the role to complete administrative and clerical tasks and visually observe patients on the unit and in therapeutic activities.

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All employment at “UHS” is with one of the subsidiaries of Universal Health Services, Inc., including its management company, UHS of Delaware, Inc. Universal Health Services is a holding company.

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