Social Worker-UM - Mental Health Services

Company: CARLE
Location: Bloomington
Posted on: September 22, 2022

Job Description:

Sign on bonus

• 1 or more years of experience - $2,500
• Less than 1 year of experience - $1,000 To provide consultant capacity within the multidisciplinary care team, facilitating psychosocial screening, collaborating with care teams to manage patients psychosocial and behavioral health issues. Utilize Milliman/Interqual/Midas to assist with establishing clinical criteria for admission, treatment, and discharge.
  • Utilize Milliman (Interqual) criteria to assist with establishing clinical criteria for admission, to monitor clinical progression, to evaluate criteria for continued stay, and to establish an anticipated discharge date
  • Contact insurance companies and provides required information to obtain Medicaid or insurance authorization for admission, complete continued stay reviews, or obtain authorization for services
  • Records required information to track pertinent patient information, IE: MIDAS, Meditech, Epic, and appropriate referral software programs
  • Performs preauthorization related to admission needs
  • Assists with denial notifications and the appeal process
  • Works with hospital case management to assist with challenges related to discharge to assure the best outcome for patients
  • Initial authorizations for Addiction Recovery In Patients, Intensive Out Patients, Partial Hospitalization Patients, and Continuing Care Patients
  • Initial authorizations for Mental Health In Patients
  • Concurrent reviews
  • Discharge reviews
  • Functions as class facilitator as needed.
  • Proficiency with Word, Excel, and Power Point is an added benefit.

Keywords: CARLE, Bloomington , Social Worker-UM - Mental Health Services, Healthcare , Bloomington, Illinois