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Clinical Review Nurse - TX Licensed

Company: VirtualVocations
Location: Fairfax
Posted on: November 20, 2024

Job Description:

A company is looking for a Clinical Review Nurse - Concurrent Review to perform concurrent reviews and evaluate the necessity of medical care for members.



Key Responsibilities

Perform concurrent reviews to assess member health and appropriate level of care
Collaborate with healthcare providers to approve medical determinations and provide recommendations
Document findings and assist in discharge planning according to care policies and guidelines


Required Qualifications and Education

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
Active LPN or RN licensure required
Knowledge of Medicare and Medicaid regulations preferred
Experience with utilization management processes preferred

Keywords: VirtualVocations, Bel Air South , Clinical Review Nurse - TX Licensed, Healthcare , Fairfax, Maryland

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