Florida Licensed Clinical Review Nurse

Job Summary

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

Key Responsibilities

• Performs concurrent reviews to determine the 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 discuss member care and improve utilization processes

Required Qualifications

• 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
• Knowledge of Medicare and Medicaid regulations preferred
• Knowledge of utilization management processes preferred
• LPN - Licensed Practical Nurse - State Licensure required