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Children's Receiving Home
…reports, health questionnaires, and termination reports as required. Continuously review charts for new and/or relevant information concerning clients. Prepare
…with Guidewire, and Paracentesis. * Shall participate in quality management and utilization review activities, as needed, clinical conferences for staff and
…additional clinical documentation, negotiating with payers, or following up with payer utilization review departments in attempts of obtaining authorizations and
…on all consumers.Cooperates with consumer's insurance carrier for service authorization/ utilization review purposes, providing information required for such
…the needs of third party payers in a timely manner. Assist in admissions review , concurrent reviews and discharge planning.Assist physician in peer review by
City of the Heart Psychological Services, Inc.
…setting with severely mentally ill adults/children. Experience in quality assurance or utilization review activities. Experience with managed care or insurance
…quality, and contract requirements * Serve as a physician member of the Utilization Review Committee, which may require non-clinical medical staff privileges
…team assigned to the facility. * Participate in case reviews, consultations, and utilization review . * Be a resource for the primary care physicians.
…patient assessments and determine appropriate levels of care Administer benefits, review treatment plans, and coordinate transitions between various areas of care
…program completion or Master's Degree in Behavioral Health or related fieldCurrent CSAC or Behavioral Health license (LPC, LCSW, LCAS)Minimum 4 years of direct