Indiana Licensed Clinical Review Nurse

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

Key Responsibilities

Perform concurrent reviews to determine member's overall health and appropriate level of care

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

Collaborate with healthcare providers and Medical Affairs to validate medical necessity and care delivery

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 at least 2 years in acute care

Active LPN or RN license required

Knowledge of Medicare and Medicaid regulations preferred

Familiarity with utilization management processes preferred