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State Licensed Clinical Review Nurse

7/9/2025

Remote

Job Summary

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

Key Responsibilities
  • Perform concurrent reviews to determine member's overall health and appropriate level of care
  • Review quality and continuity of care, including acuity level and discharge planning
  • Collaborate with healthcare providers and leadership to improve care quality and compliance with policies
Required Qualifications
  • 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
  • Active LPN or RN licensure required
  • Knowledge of Medicare and Medicaid regulations preferred
  • Familiarity with utilization management processes preferred

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