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California RN Clinical Review Nurse

Company: VirtualVocations
Location: Saint Petersburg
Posted on: November 1, 2024

Job Description:

A company is looking for a RN Clinical Review Nurse - Concurrent Review to perform concurrent reviews and evaluate the necessity of care for members.



Key Responsibilities

Perform concurrent reviews to assess members' overall health and treatment needs
Evaluate the medical necessity and appropriateness of the care being delivered
Contribute to discharge planning in accordance with care policies and guidelines


Required Qualifications and Education

Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing
2 - 4 years of related experience, including 2+ years of acute care experience
Clinical knowledge to determine members' overall health and treatment needs
Knowledge of Medicare and Medicaid regulations preferred
RN license required for Health Net of California

Keywords: VirtualVocations, Spring Hill , California RN Clinical Review Nurse, Healthcare , Saint Petersburg, Florida

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