Arkansas Licensed Clinical Review Nurse

Job Summary

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

Key Responsibilities

• Performs concurrent reviews to determine overall health and appropriate level of care for members
• Reviews quality and continuity of care, including acuity level and discharge planning
• Collaborates with healthcare providers and Medical Affairs to approve medical determinations and improve care quality

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 in acute care required
• Knowledge of Medicare and Medicaid regulations preferred
• LPN licensure required; RN licensure highly preferred
• Experience in adult, pediatric, maternity, and behavioral health services preferred