Performing concurrent reviews to evaluate member health and care delivery, the full-time Concurrent Review Nurse - Multi-State Licensed will work remotely, assessing medical necessity and contributing to discharge planning while collaborating with healthcare providers and medical directors. Key responsibilities Conducts concurrent reviews to determine the appropriateness of care and setting for members Reviews quality and continuity of care, including acuity levels and discharge planning Collaborates with healthcare providers to approve medical determinations based on concurrent review findings Required qualifications Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing 2 - 4 years of related experience, with at least 2 years in acute care Active multi-state nursing licensure in good standing Knowledge of Medicare and Medicaid regulations preferred Familiarity with utilization management processes preferred
Concurrent Review Nurse - Multi-State Licensed in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.