A company is looking for a Clinical Review Nurse - Concurrent Review.
Key Responsibilities
Performs concurrent reviews to determine members' overall health and appropriate level of care
Reviews quality and continuity of care, including acuity level, resource consumption, and discharge planning
Collaborates with healthcare providers and assists with 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 determine overall health and treatment needs preferred
Knowledge of Medicare and Medicaid regulations preferred
LPN or RN - FL State Licensure required
Clinical Review Nurse • North Hollywood, California, United States