Tennessee Licensed Clinical Review Nurse

Job Summary

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

Key Responsibilities

• Perform concurrent reviews to determine overall health and appropriate level of care for members
• Review quality and continuity of care, including acuity levels and discharge planning
• Collaborate with healthcare providers and medical directors to discuss member care and validate medical determinations

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
• LPN - Licensed Practical Nurse - State Licensure required; RN license preferred
• Clinical knowledge to determine overall health and treatment needs preferred
• Knowledge of Medicare and Medicaid regulations and utilization management processes preferred