Nevada 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 acuity levels and discharge planning

Collaborates with healthcare providers and Medical Affairs to validate care and approve 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

Knowledge of Medicare and Medicaid regulations preferred

Knowledge of utilization management processes preferred

LPN or RN license required, depending on location