A company is looking for a Clinical Review Nurse - Concurrent Review.
Key Responsibilities
Performs concurrent reviews to assess member health and appropriateness of care
Reviews quality and continuity of care, including acuity levels and discharge planning
Collaborates with healthcare providers and Medical Affairs to validate care decisions
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) state licensure required
Clinical knowledge to assess member health and treatment needs preferred
Knowledge of Medicare and Medicaid regulations preferred
Clinical Review Nurse • Toledo, Ohio, United States