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North Carolina Licensed Clinical Review Nurse
A company is looking for a Clinical Review Nurse - Concurrent Review. Key Responsibilities Perform concurrent reviews to determine members' overall health and appropriate level of care Review quality and continuity of care, including acuity level, resource consumption, and discharge planning Collaborate with healthcare providers and leadership to improve care quality and ensure compliance with utilization management policies Required Qualifications, Training, and Education 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 Active LPN or RN licensure in North Carolina or a compact RN/LPN credential from another state Clinical knowledge to assess members' health and treatment needs Knowledge of Medicare and Medicaid regulations and utilization management processes preferred
A company is looking for a Clinical Review Nurse - Concurrent Review.
Key Responsibilities
Perform concurrent reviews to determine members' overall health and appropriate level of care
Review quality and continuity of care, including acuity level, resource consumption, and discharge planning
Collaborate with healthcare providers and leadership to improve care quality and ensure compliance with utilization management policies
Required Qualifications, Training, and Education
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
Active LPN or RN licensure in North Carolina or a compact RN/LPN credential from another state
Clinical knowledge to assess members' health and treatment needs
Knowledge of Medicare and Medicaid regulations and utilization management processes preferred
