Case Management Coordinator - Utilization Review Specialist

Acadia Healthcare

  • New Castle, DE
  • Permanent
  • Full-time
  • 2 months ago
Description :Education: Must have a Bachelors degree; Masters degree or RN license preferred.Assure residents meet criteria for admission, and review initial clinical information through discharge.Monitor and manage client/patient/resident’s cases through development and implementation of individual care plans, collecting clinical data and remain informed by continuous review of documentation.Coordinate care by tracking, monitoring, and reporting on inpatient or outpatient care.Manage client/patient/resident’s cases with knowledge and expertise with the patient population of the facility.Convey medical criteria and clinical information between the client/patient/residents’ insurance provider and treatment team as warranted and may also provide this information to the business office, as needed.Conduct precertification with third party payers and negotiate approved days with the provider for the patient/resident admission.Assigned tasks for admission review, concurrent review and participate in discharge planning.Skills : Customer Focus: Required Advanced
Communication: Required ExpertBehaviors : Detail Oriented: Capable of carrying out a given task with all details necessary to get the task done well
Team Player: Works well as a member of a groupMotivation : Ability to Make an Impact: Inspired to perform well by the ability to contribute to the success of a project or the organizationEducation : Masters
BachelorsExperience : 1 years: Ability to create and maintain professional liaison with community agencies and organizations to ensure continuity of care. Knowledge of mental health and substance abuse fields is preferred.Licences & certifications Reg Nurse

Acadia Healthcare