Clinical Review Nurse - Concurrent Review LPN

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