Texas Licensed Clinical Review Nurse

Job Summary

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

Key Responsibilities

• Perform concurrent reviews to determine member's overall health and appropriate level of care
• Review quality and continuity of care, including discharge planning and resource consumption
• Collaborate with healthcare providers and Medical Affairs to discuss member care and approve medical determinations

Required Qualifications

• Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing
• 2 - 4 years of related experience, with 2+ years in acute care required
• Licensed Practical Nurse (LPN) or Registered Nurse (RN) state licensure required
• Preferred 3+ years of direct patient care experience in various acute care settings
• Knowledge of Concurrent Review and Utilization Management processes preferred