Performing concurrent reviews, the full-time Illinois Licensed Clinical Review Nurse will evaluate members' health, assess the appropriateness of care, and contribute to discharge planning in a remote setting, supporting the YouthCare program. Key responsibilities: Conduct concurrent reviews to determine overall health and appropriate level of care for members Collaborate with Medical Affairs and healthcare providers to validate medical necessity and approve care determinations Document concurrent review findings and discharge plans in health management systems according to guidelines 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 Current Illinois RN licensure Familiarity with Medicare and Medicaid regulations preferred Knowledge of utilization management processes preferred
Illinois Licensed Clinical Review Nurse in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.