Nevada Licensed Clinical Review Nurse

Job Summary

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

Key Responsibilities

• Performs concurrent reviews of members to determine 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 directors to discuss member care and approves 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 of acute care experience required
• RN-NV State Licensure required
• Knowledge of Medicare and Medicaid regulations preferred
• Familiarity with utilization management processes preferred