RN Reviewer

Description:
The Reviewer reports to the Inpatient Project Director and is a member of the inspection of care team. As a member of that team, the nurse is responsible for conducting a compliance audit and reviewing the medical records for medical necessity criteria. When not conducting an inspection of care, the RN reviewer is responsible for reviewing requests for services based on medical necessity criteria promulgated by DBHS/DMS; authorizing proposed treatment plans; referring cases to the Care Coordinators, and consulting with physicians. The Reviewer staff communicates with providers in the community regarding service requests.Visit our website at:www.apshealthcare.comReferral bonus available to APS Healthcare Employees*
In accordance to guidelinesAPS HEALTHCARE Bethesda, Inc. and its subsidiaries and affiliates (APS) are Equal Opportunity Employers which employ qualified individuals based upon job related qualifications regardless of race, religion, color, sex, national origin, age, disability, or any other classification proscribed under applicable federal, state, or local law. APS complies with the law regarding reasonable accommodation for disabled employees. Applicants requiring reasonable accommodation in order to participate in the interview process are requested to contact Human Resources in order to arrange such accommodation.
REQUIREMENTS
Requirements:
Ability to resolve problems in a non-threatening manner. Experience in child and adolescent mental health treatment Strong verbal and written communication skills Customer service focus Ability to travel to participate in inspections of care At least 3 years experience in mental health treatment with children/adolescents and at least 1 year experience in utilization review, supervision, or administration.
Education:
R.N. or a Master’s Degree in Nursing; Current Arkansas license.