Missouri Licensed Clinical Review Nurse

Job Summary

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

Key Responsibilities

• Performs concurrent reviews to assess member health and appropriate level of care
• Reviews quality and continuity of care, including discharge planning and resource consumption
• Collaborates with healthcare providers and leadership to improve care and validate medical necessity

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 of acute care experience required
• Knowledge of Medicare and Medicaid regulations preferred
• Knowledge of utilization management processes preferred
• LPN State Licensure required; RN License preferred