New 
Clinical Review Nurse - Concurrent Review
 Spectraforce Technologies | |||||||||||||||||||||||||||||
 United States, Texas, Texas City | |||||||||||||||||||||||||||||
 Feb 20, 2025 | |||||||||||||||||||||||||||||
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Title: Clinical Review Nurse - Concurrent Review Duration- 6 Months Remote- TX Description: Performs concurrent reviews, including determining member's overall health, reviewing the type of care being delivered, evaluating medical necessity, and contributing to discharge planning according to care policies and guidelines. Assists evaluating inpatient services to validate the necessity and setting of care being delivered to the member. Clinical knowledge and ability to determine overall health of member including treatment needs and appropriate level of care preferred. Knowledge of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred.
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