Director of Utilization Review and Case Management
Keith is originally from Rhode Island. He is a Navy veteran. Keith obtained his nursing degree at Coastal Carolina College. He is an advocate for patient care and the liaison between insurance companies and clients for Verification of Benefits (VOB). As the director of utilization review, he secures patient’s initial authorization and for additional residential rehabilitation care as needed for in-house addiction and mental health treatment. Keith also handles insurance process reporting.
As the director of utilization review and case management Keith’s job entails the following:
- Compiling all the information necessary before contacting the insurance company
- Responsible for management of the day-to-day operational functions of the Health Services Department
- Leads and supports the revision of the Utilization Management and CM Manual on an annual basis and as needed
- Leads and support the development and implementation of and new Policies and Procedures to the UM and CM program
- Reports outcome studies for continued JACHO accreditation
Supports and supervises the management of in-patient activities/processes, including, but not limited to:
- Concurrent and retrospective reviews
- Authorization of appropriate lengths of stay
- Authorization of appropriate discharge services and aftercare planning
- Documentation of all authorized or denied services
Keith also loves cooking fine cuisine, grilling, any activity on the water and Oreo – his cocker-spaniel.