Texas Licensed Clinical Review Nurse

A company is looking for a Clinical Review Nurse - Concurrent Review.

Key Responsibilities

Perform concurrent reviews to assess member health and appropriate level of care

Review quality and continuity of care, including acuity levels and discharge planning

Collaborate with healthcare providers and Medical Affairs on care determinations and recommendations

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

Compact RN or LVN / LPN License required

Knowledge of Medicare and Medicaid regulations preferred

Familiarity with utilization management processes preferred