Missouri and Kansas Licensed Clinical Review Nurse

Job Summary

A company is looking for a Clinical Review Nurse.

Key Responsibilities

• Conducts utilization management reviews to ensure appropriate healthcare system use and maximize healthcare dollars
• Reviews medical information to determine medical necessity, benefits, and eligibility for services and products
• Communicates with team members and providers to assess and educate on healthcare resources and improve outcomes

Required Qualifications

• Associate degree in nursing
• 3+ years of full-time direct patient care clinical experience in medical/surgical, pediatrics, and/or obstetrics
• RN license in Missouri and Kansas
• Proven experience in problem definition and data collection to solve practical problems
• Experience presenting information to groups and responding to questions from various stakeholders