Iowa Licensed Clinical Review Nurse

Job Summary

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

Key Responsibilities

• Performs concurrent reviews to assess member 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 validate medical determinations

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
• State licensure as a Licensed Practical Nurse (LPN) is required
• Clinical knowledge to determine overall health and treatment needs preferred
• Familiarity with Medicare and Medicaid regulations preferred