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
Clinical Review Nurse • Lincoln, Nebraska, United States