Arizona Licensed Clinical Review NurseVirtualVocations • Salinas, California, United States
Arizona Licensed Clinical Review Nurse
VirtualVocations • Salinas, California, United States
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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 Affairs to ensure appropriate care and 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 2+ years in acute care required
Licensed Practical Nurse (LPN) or Registered Nurse (RN) license required
Clinical knowledge to assess member health and treatment needs preferred
Knowledge of Medicare and Medicaid regulations and utilization management processes preferred
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Clinical Review Nurse • Salinas, California, United States
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