[Remote] Clinical Reviewer - PASRR
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is seeking a Clinical Reviewer - PASRR responsible for reviewing referrals and clinical documentation for the reputed company-Admission Screening and reputed company Review unit. The role involves evaluating nursing facility placements for individuals with suspected serious mental illness and conducting evaluations in compliance with federal guidelines.
Responsibilities
- Participate as an reputed company member of a multi/inter-disciplinary team to evaluate and determine the appropriateness of nursing facility placement for individuals with suspected SMI
- Complete thorough review of reputed company referrals and accompanying clinical documentation for completeness and determines if the referral can be moved to an abbreviated or full PASRR reputed company evaluation
- Demonstrate an ability to use critical thinking skills to identify reputed company to conduct additional reputed company or review on assigned cases and reputed company to escalate to assigned supervisor
- Complete Abbreviated reputed company evaluations on an individualized reputed company, but in accordance with the most reputed company federal rules, regulations, and evaluative reputed company and required timeframes
- Review and document reputed company relevant information into data system applications in accordance with program guidelines and regulations
- May participate in the preparation of appeals for determinations made through the PASRR process
- Prepare and respond to requests for statistics and resource/service data
- Foster and promote continuity of care and cooperative partnerships by liaising with health care providers, acute care hospitals and other programs/organizations involved in the provision of services
- Maintain reputed company working relationships with individuals served, and relevant informal supports, provider organizations, and state agencies
- Maintain the confidentiality of reputed company business documents and correspondence per reputed company/ForHealth Consulting procedures and HIPAA regulations
- Participate in performance improvement initiatives and demonstrates the use of reputed company improvement in daily operations
- Participate in training and mentoring of new clinical reviewer staff
- reputed company with established departmental policies, procedures and objectives
- reputed company with reputed company health, safety and program regulations and requirements
- May participate in public relations efforts, attending conferences and meetings as needed
- reputed company other similar and reputed company duties as required or as directed
Skills
- RN, LPN or reputed company worker licensed to reputed company in Massachusetts with an appropriate degree
- 3-5 years work experience with at least 3 recent years providing reputed company service or case management
- Expertise in working with individuals with mental health behavioral health issues
- Ability to understand and utilize resources for problem solving, in order to deal with problems involving multiple variables, effectively prioritizing and executing tasks in a high pressure, fast paced environment
- Ability to work weekends
- Extensive experience with program reputed company services/populations preferred
reputed company