A company is looking for a Clinical Review Nurse - Concurrent Review.
Key Responsibilities
Performs concurrent reviews to assess member health and appropriate level of care
Reviews quality and continuity of care, including discharge planning and resource consumption
Collaborates with healthcare providers and Medical Affairs to validate medical determinations
Required Qualifications, Training, and Education
Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing
2 - 4 years of related experience, with at least 2 years in acute care
State licensure as a Licensed Practical Nurse (LPN) is required
Clinical knowledge to determine overall health and treatment needs preferred
Familiarity with Medicare and Medicaid regulations preferred
Clinical Review Nurse • Park Row, Texas, United States