New York RN Clinical Review Nurse

A company is looking for an RN 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 and discharge planning

Collaborates with healthcare providers and assists in approving medical determinations based on concurrent review findings

Required Qualifications

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

Current NY RN Licensure

Clinical knowledge to determine overall health and treatment needs preferred

Knowledge of Medicare and Medicaid regulations preferred