Indiana Licensed Clinical Review Nurse

Job Summary

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

Key Responsibilities

• Performs concurrent reviews to determine member's overall health and appropriate level of care
• Reviews quality and continuity of care, including discharge planning and resource consumption
• Collaborates with healthcare providers and Medical Affairs to discuss member care and approvals

Required Qualifications, Training, and Education

• Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing
• 2 - 4 years of related clinical experience, with at least 2 years in acute care
• Current IN or Compact State Nursing License
• Post Acute Care and Clinical Review experience preferred
• Knowledge of Medicare and Medicaid regulations and utilization management processes preferred