Indiana Licensed Clinical Review Nurse

A company is looking for a Clinical Review Nurse - Concurrent Review.

Key Responsibilities

Performs concurrent reviews to determine member's overall 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 discuss member care and approvals

Required Qualifications, Training, and Education

Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing

2 - 4 years of related clinical experience, with at least 2 years in acute care

Current IN or Compact State Nursing License

Post Acute Care and Clinical Review experience preferred

Knowledge of Medicare and Medicaid regulations and utilization management processes preferred