Pennsylvania Licensed Clinical Review Nurse
Job Summary
To support healthcare delivery, the full-time Pennsylvania Licensed Clinical Review Nurse will perform concurrent reviews to assess members' overall health, evaluate the necessity of care, and contribute to discharge planning while working remotely from Pennsylvania.
Key responsibilities
- Conducts concurrent reviews of members to determine appropriate care and setting based on overall health and medical necessity
- Collaborates with Medical Affairs and healthcare providers to validate care delivery and approve medical determinations
- Documents concurrent review findings and discharge plans in health management systems according to utilization management policies
Required qualifications
- Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing
- 2 - 4 years of related experience, including 2+ years of acute care experience
- Current RN - Registered Nurse State Licensure or Compact State Licensure
- Knowledge of Medicare and Medicaid regulations preferred
- Experience in case management or utilization management (UM/UR) highly preferred
Complete Job Description
The complete job description is available to members. Premium membership includes:
Full access to 41,015 remote jobs from human-vetted companies, updated daily
Resume Builder - AI-powered tool to craft, enhance, and tailor your resume to a specific job
Twice-monthly live group coaching and the full Remote Career Center
20% member discount on Career Services
Backed by a 30-day money-back guarantee
Company Company Name
Headquarters Headquarters
Founded Founded
Website
Wikipedia Wikipedia URL
BBB URL BBB URL
The company description is available to members. Go Premium for full access to every job and company profile in our remote jobs database, backed by a 30-day money-back guarantee.
