Vitality Unlimited and Vitality Integrated Programs is seeking an RN to help assess the needs of our clients who are in treatment, walk-in o calling in to ensure their referral to the service or resource to best address those needs.
What You’ll Be Doing:
- Performs and monitoring activities for mental health and substance abuse problems
- Acts as a member advocate by expediting the care process through the continuum, working in concert with the health care delivery team to maintain high quality and cost-effective care delivery.
- Determines medical necessity and appropriateness of services using clinical review criteria based information given by providers.
- Accurately documents all review determinations and contacts providers and members according to established timeframes.
- Identifies and refers cases that do not meet established clinical criteria to the Program Manager.
- Identifies and refers quality issues to the Program Manager.
- Identifies potential cases for Care Management programs.
- Performs accurate data entry in order to meet quality goals.
- Communicates information to other staff members as necessary/required.
- Participates in continuing education initiatives.
- Collaborates with Claims, Quality Management and Provider Relations Departments as requested.
- Other duties as assigned.
Responsibilities and Duties
- Responds to client concerns either by telephone or on a face-to-face basis regarding their behavioral health needs or information about mental health-related services.
- Participate in medical emergencies through a systematic process of interaction with patients, the patient's significant others, and the appropriate health care providers,
- Collects and analyzes data regarding the client's physical, psychosocial, environmental, self-care, educational, spiritual, cultural, and anticipated discharge needs.
Qualifications and Skills
- RN in the State of Nevada required.
- Ability to deal with crisis and potentially combative patients while maintaining personal and emotional equilibrium
- Knowledge of diagnostic criteria
- Knowledgeable of patient rights and laws pertaining to mental health
- Outstanding oral communication, assessment and intervention skills
- Experience in a Behavioral Health facility strongly preferred
- Basic personnel management or supervisory skills helpful
Employment Type: Full Time
Years Experience: 3 - 5 years
Salary: $83,000 - $87,500 Annual