Clinician

• Conduct intake interviews and assess client.
• Prepare goal-oriented psychosocial diagnostic assessments, service plans and progress reports.
• Provide case consultations, one-to-one counseling for clients, and/or crisis intervention.
• Maintain therapeutic services within National EMR and funding source guidelines.
• Develop and implement client tracking and status reports for monthly review/audit of clinical department.
• Provide data to support staff on admission/discharge of clients for them to maintain the permanent National EMR Census.
• Monitor and assist caseworkers and case aides in client supervision and milieu activities.
• Participate in or facilitate primary therapeutic/psycho educational groups or activities.
• Interview and complete preliminary service plan for each assigned client within 72 business hours.
• Participate in weekly scheduled case staffing with the treatment team to review clients' progress and compliance.
• Review client files to ensure proper documentation of therapeutic plan/services.
• Obtain and maintain working knowledge of State Licensing Standards and funding source guidelines.
• Attend and participate in twenty (20) hours of continuing education a year to maintain certifications dependent on current licensure.
• Other duties as assigned.

PRN Mental Health Clinician supporting emergency response teams and clients

Mental Health Clinician

PRN Mental Health Clinician supporting mental health needs of clients in emergency situations. Conducting assessments, providing counseling, and tracking client progress as part of an all-hazards response team.

• Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance with policies, guidelines, and NCQA standards
• Prepares case reviews for Medical Directors by researching the appeal, reviewing applicable criteria, and analyzing the basis for the appeal
• Ensures timely review, processing, and response to appeal in accordance with State, Federal and NCQA standards
• Communicates with members, providers, facilities, and other departments regarding appeals requests
• Generates appropriate appeals resolution communication and reporting for the member and provider in accordance with company policies, State, Federal and NCQA standards
• Works with leadership to increase the consistency, efficiency, and appropriateness of responses of all appeals requests
• Partners with interdepartmental teams to improve clinical appeals processes and procedures to prevent recurrences based on industry best practices
• Performs other duties as assigned
• Complies with all policies and standards

Clinical Review Clinician performing appeals reviews in behavioral health for Centene.

Clinical Review Clinician – Appeals, Behavioral Health

Clinical Review Clinician performing behavioral health appeals reviews for Centene's Medical Management team. Responsible for ensuring compliance with clinical data, policies, and NCQA standards.

• Deliver proactive coding education through newsletters, scorecards, and presentations
• Lead onboarding and compliance training for all employed Physicians/APPs
• Provide individualized documentation feedback by reviewing new clinician records
• Serve as the primary contact for coding inquiries
• Monitor Epic work queues to ensure timely and accurate charge submissions
• Collaborate across departments to enhance documentation practices

Clinician Coding Liaison ensuring accurate coding in ENT/Audiology

Clinician Coding Liaison – ENT, Audiology

Clinician Coding Liaison providing proactive coding education and support for ENT/Audiology. Ensuring compliance and documentation accuracy through collaboration and training within the healthcare team.

Clinician jobs in Wisconsin

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Mental Health Clinician

Clinical Review Clinician – Appeals, Behavioral Health

Clinician Coding Liaison – ENT, Audiology