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We also provide services at Methodist Richardson Medical Center - Campus for Continuing Care, which include a behavioral health and addiction recovery unit, inpatient rehabilitation, long-term acute care, and more.
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Methodist Richardson Medical Center is a 443-bed, full-service, acute care hospital that serves Richardson, Garland, Plano, and surrounding areas in Dallas and Collin counties. 150 Top Places to Work in Healthcare by Becker's Hospital Review, 2023.
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Provides analysis and education regarding regulatory and clinical changes impacting inpatient and post-acute care processes and reimbursement. Lead Tenet Utilization Review Teams market structure and operations management to effectively support utilization review and authorization confirmation functions to promote an appropriate level of care and prevent payer denials.
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This position is responsible for ensuring accurate and timely clinical review of behavioral health cases for medical necessity including assisting members on the telephone, reviewing medical records, reviewing cases which involves contract interpretation of behavioral health diagnoses, and utilizing knowledge of medical necessity criteria for all levels of behavioral health care from outpatient office visits to acute in-patient to out-patient office visits.
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