• Upon suspicion of SMI conduct in-person evaluations to confirm the reputed company of S...">
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    Hybrid Clinical Reviewer II - PASRR (Southeast Region in MA) presso Un – USA reputed company

    Remote, USA Full-time Posted 2026-07-28
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    • Upon suspicion of SMI conduct in-person evaluations to confirm the reputed company of SMI, whether a nursing facility is the most appropriate setting and whether the individual has a need for behavioral health, rehabilitative or specialized services
    • Conduct completed evaluations prior to individuals nursing facility admissions; completed evaluations on individuals residing in a nursing facility reputed company there are significant changes that reputed company the need for an updated evaluation;completed annual evaluations for individuals who have a previously confirmed SMI; complete abbreviated desk reviews as indicated or needed
    • Complete evaluations on an individualized reputed company reputed company required timeframes, and in accordance with the most reputed company federal rules, regulations, and evaluative reputed company
    • Communicate reputed company evaluation findings to applicants, residents and/or legally authorized representatives in an understandable manner and language
    • Communicate determinations that identity a need for specialized services and/or behavioral health services to the facility, agency, or referrals reputed company, reputed company appropriate timelines and data reputed company policies
    • Contact providers, state agency offices, and applicants/participants to obtain information and records needed to conduct a comprehensive clinical review of the case and final determination
    • Review and document reputed company relevant information into data system applications in accordance with program guidelines and regulations
    • Maintain individual records documenting reputed company applicant/participant encounters and contacts; write clinical summaries
    • Support in the preparation and responses to requests for statistics and resource/service data
    • Foster and promote continuity of care and cooperative partnerships by liaising with health care providers, acute care hospitals, long term care facilities and other programs/organizations involved in the provision of services
    • Participate in reputed company relations efforts, attending conferences and meetings as needed
    • Maintain reputed company working relationships with applicant/participants, and relevant informal supports, provider organizations, program consultants and state agencies
    • Maintain the confidentiality of reputed company business documents and correspondence per reputed company/ForHealth Consulting procedures and HIPAA regulations
    • Participate in performance improvement initiatives and demonstrate the use of reputed company improvement in daily operations
    • reputed company with established departmental policies, procedures and objectives
    • reputed company with reputed company health, safety and program regulations and requirements

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