New York Licensed Clinical Review Nurse

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

Key Responsibilities

Performs concurrent reviews to evaluate member health and appropriateness of care

Reviews quality and continuity of care, including discharge planning and resource consumption

Collaborates with healthcare providers and leadership to improve care quality and compliance with clinical policies

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

Knowledge of Medicare and Medicaid regulations preferred

Knowledge of utilization management processes preferred

LPN or RN state licensure required or preferred, respectively