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Title

CSS Utilization Review Manager. 

About the Organization Catholic Charities, Diocese of Trenton is a faith inspired non-profit organization, mission-driven, family-friendly, and passionate about services to our communities. We offer a wide variety of exciting career opportunities in the areas of Direct Care, Clinical, Fundraising, Human Resources, IT, Finance, Marketing, and Nursing. When you join us, you can expect a true focus on work-life balance, competitive salaries, comprehensive benefit programs, and an environment that promotes inclusion. Some of our benefits include: generous paid Holidays, Vacation, and Sick time; excellent health & pension plans; and wide array of training and staff development opportunities to earn on-site CEUs. Catholic Charities is an Affirmative Action / Equal Opportunity Employer, fostering a diverse and inclusive environment for staff as well as for people seeking assistance. To learn more about the agency, please visit our website at: www.catholiccharitiestrenton.org.



This position may be subject to Executive Order 283, requiring a proof of being up-to-date with COVID-19 vaccination, including any recommended booster. Requests for reasonable accommodation based on medical condition, disability, or sincerely-held religious belief precluding vaccination will be considered and should be made to Human Resources: 609-394-5181.



 
Req Number DIR-22-00093  
Location BHS - Riverbank (Burlington, NJ)  
Full-Time/Part-Time Full-Time  
Number of Openings 1  
Category Direct Care - Professionals / Paraprofessionals  
Description

JOB SUMMARY: Responsible for ensuring that Progress Notes and IRP's are completed on time. That notes, plans and all forms meet State and Federal Licensing requirements so that CCDoT can bill for services provided. Monitors and may recommend an increase or decrease in level of care based upon consumer's mental health condition and willingness to engage in treatment. Collects information required to authorize services, assess necessity and appropriateness of treatment. Develops relationships with psychiatrists, APN's, healthcare service providers and internal and external customers to help improve mental health outcomes for consumers.

ESSENTIAL FUNCTIONS:

   1. Audit Charts, Progress Notes, and IRP's to ensure they meet standards and deadlines.

   2. Review Suspense reports. Problem solve suspense/billing issues

   3. Verify consumer insurance through the eMevs system.

   4. Ensure consumers are insured for billing via Molina certification.

   5. Regular contact with IME to verify status of IRP's. Record & track status of all IRP's.

   6. Complete weekly bed and vacancy reports. 

   7. Develop forms to track status of projects.

   8. Work with Residential Program Directors on gathering necessary data to complete and submit

       quarterly QCMR reports to DMHAS

   9. Provide input to Program Director regarding consumer needs, staff training and overall concerns.

 10. Contribute to the development and updating of individualized rehabilitation plans.

 11. Communicate, in written & verbal form, assessments & observations of consumers to other

       treatment team members.

 12. Responsible for maintaining electronic and paper charts which includes required documentation of

        service agreements, complaints and grievances, consumer rights, IRPs and nursing assessments

 13. Proactive assistance with screening, interviewing, new hire orientation and targeted training.

 14. Collaborate with Director of Training and Standards Compliance to Review and revise PDSA

       systems

 15. Provides Anasazi training to staff as well as demonstrates solid competencies with navigating

       Anasazi system. Demonstrate solid competencies with entering data into contractor systems.

 16. Participate in weekly treatment team meetings

 17. Assist Housing Specialists and Group Home mangers with consumer intake at time of admission

 18. Identify and provide additional training needs in consultation with Director of Residential Services

       for Housing Specialists and Group Home managers related to billable hours, units of service

       produced, and required agency and state reports

 19. Assist Director of Training and Standards Compliance in ensuring residential staff remain in

       compliance with agency and state regulations.

 20. Other duties as assigned by Director of Residential Services and BHS and Agency Leadership.

KNOWLEDGE/SKILLS/ABILITIES: Ability to multi-task and handle various responsibilities/duties/issues simultaneously while meeting timelines. Detail and problem solving oriented, possess strong organizational skills, excellent interpersonal, written and verbal communication  skills, the ability to establish positive interpersonal relationships with staff and colleagues, as well as external community for networking and partnership building.

SUPERVISORY REQUIREMENTS:     N/A

 
Position Requirements

MINIMUM QUALIFICATIONS: A Bachelor’s degree from an accredited college or university preferred; OR a combination of one or more years of college and work experience equaling four years; Or a High School Diploma with four years work experience.

 

 

LICENSES/CERTIFICATIONS NEEDED: Valid Driver's License

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Exempt/Non-Exempt Exempt  
Weekly Work Hours 40  
Schedule Monday-Friday 8:30am- 4:30pm 

This position is currently accepting applications.

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