California RN Clinical Review Nurse

VirtualVocations
Littleton, Colorado, United States
Full-time

A company is looking for a RN Clinical Review Nurse - Concurrent Review to perform concurrent reviews and evaluate the necessity of care for members.

Key ResponsibilitiesPerform concurrent reviews to assess members' overall health and treatment needsEvaluate the medical necessity and appropriateness of the care being deliveredContribute to discharge planning in accordance with care policies and guidelinesRequired Qualifications and EducationGraduate from an Accredited School of Nursing or Bachelor's degree in Nursing2 - 4 years of related experience, including 2+ years of acute care experienceClinical knowledge to determine members' overall health and treatment needsKnowledge of Medicare and Medicaid regulations preferredRN license required for Health Net of California

5 days ago
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