Clinical Review Nurse - Concurrent Review LPN

Location: Remote
Compensation: Hourly
Staff Reviewed: Thu, Feb 08, 2024
This job expires in: 14 days

Job Summary

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

Key Responsibilities:
  • Perform concurrent reviews to determine member's overall health, evaluate medical necessity, and contribute to discharge planning
  • Review quality and continuity of care by assessing acuity level, resource consumption, length of stay, and discharge planning
  • Collaborate with healthcare providers, collect and document review findings, and provide education on utilization processes

Qualifications:
  • Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing
  • 2-4 years of related experience
  • LPN - Licensed Practical Nurse - State Licensure required
  • Clinical knowledge and ability to determine overall health of member preferred
  • Knowledge of Medicare and Medicaid regulations and utilization management processes preferred

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