Step-Down Patient Care Navigator
Three Rivers Behavioral Health · West Columbia, SC · 3 mo ago
On-siteInformation TechnologyFull-time
Responsibilities
- Maintains current awareness of Outpatient programming.
- Maintains Midas data collection process.
- Identifies and communicates data driven trends in the step-down process.
- Affixes strategies, goals and objectives related to the step-down process.
- Consults with facility management, ensuring awareness of step-down trends.
- Utilization management to include participating in pre-certifications for admissions with third party payers.
- Completes Pre-Authorization for Outpatient Services.
- Performs concurrent reviews for patients to ensure that extended stays are medically justified and are documented in the patient’s medical records.
- Prepares and submits appeals to third party payors within required timeframe.
Qualifications
- Bachelor's degree in social work, psychology or related field.
- Masters' degree strongly preferred.
- Minimum of 2 years experience in behavioral health.
- CPI certification (provided upon hire).