A company is looking for a Clinical Review Nurse - Concurrent Review.
Key Responsibilities
Performs concurrent reviews to determine overall health and appropriate level of care for members
Reviews quality and continuity of care, including acuity level, resource consumption, and discharge planning
Collaborates with healthcare providers and medical directors to discuss member care and provides education on utilization processes
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 2+ years of acute care experience required
Clinical knowledge to assess member's overall health and treatment needs
Knowledge of Medicare and Medicaid regulations preferred
RN compact license preferred; LPN state licensure required
Clinical Review Nurse • Laredo, Texas, United States