ESSENTIAL FUNCTIONS:
Monitors inpatient and intermediate level of care services related to mental health treatment to ensure medical necessity and effectiveness.
Provides telephone triage, crisis intervention and emergency authorizations as assigned.
Performs concurrent reviews for inpatient care and other levels of care as allowed by scope of practice and experience. In conjunction with providers and facilities, develops discharge plans and oversee their implementation.
Provides information to members and providers regarding mental health benefits, community treatment resources, mental health managed care programs, and company policies and procedures, and criteria.
Interacts with Physician Advisors to discuss clinical and authorization questions and concerns regarding specific cases.
Participates in quality improvement activities, including data collection, tracking, and analysis.
Proposes alternative plans of treatment when requests for services do not meet medical necessity criteria.
Advocates for the patient to ensure treatment needs are met. Interacts with providers in a professional, respectful manner that facilitates the treatment process.
equirements/Certifications:
The members they service are adults. On average, the handle time for admissions are about 15-20 mins. The handle time on concurrent reviews are about 15 minutes and that depends are when the reviews are due and how many people are admitted into either IP, PHP, or IOP. This is an in-office position. Please read the description of the position.
Training:2 – 3 weeks
License: LCSW, LMFT or RN. LCSWs and LMFTs REQUIRE a Master’s Degree. RNs REQUIRES a Bachelor’s Degree
Regards,
Riya Khem
Life Science Recruiter
Integrated Resources, Inc.
IT Life Sciences Allied Healthcare CRO
(Direct) 732-844-8721 | (W) 732-549-2030 x 311 | (F) 732-549-5549
“INC 5000’s FASTEST GROWING, PRIVATELY HELD COMPANIES” (8th Year in a Row)
Job details are sourced from the employer's original posting.
Open job postingAbout the company
Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.