LPN Clinical Review Nurse

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 acuity level and discharge planning Collaborates with healthcare providers and Medical Affairs to validate medical necessity and care delivery 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 2+ years of acute care experience required LPN - Licensed Practical Nurse - State Licensure required Knowledge of Medicare and Medicaid regulations preferred Familiarity with utilization management processes preferred

Feb 14, 2025 - 13:40

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 acuity level and discharge planning Collaborates with healthcare providers and Medical Affairs to validate medical necessity and care delivery 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 2+ years of acute care experience required LPN - Licensed Practical Nurse - State Licensure required Knowledge of Medicare and Medicaid regulations preferred Familiarity with utilization management processes preferred