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  • Omaha, NE

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Concurrent Review Nurse

Omaha, NE

Posted 1 month ago

Job Snapshot

Full-Time
Experience - 2 years
Degree - 4 Year Degree
Healthcare - Health Services
Health Care

Job Description

Hours: M-F 8am-5pm

Pay: $34/Hour

Summary: Promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to emergent/urgent and continued stay reviews.

Job Responsibilities:

  • Perform onsite review of emergent/urgent and continued stay requests for appropriate care and setting, following guidelines and policies, and approve services or forward requests to the appropriate Physician or Medical Director with recommendations for other determinations
  • Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findings Collaborate with various staff within provider networks and discharge planning team electronically, telephonically, or onsite to coordinate member care
  • Conduct discharge planning
  • Educate providers on utilization and medical management processes
  • Provide clinical knowledge and act as a clinical resource to non-clinical team staff
  • Enter and maintain pertinent clinical information in various medical management systems

Job Requirements

Education/Experience: Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred Current state’s LPN/LVN or RN license.0-2 years of experience

Top 3 Skills-

  • Strong med surgical background
  • Multi-tasking/ organized
  • Computer skills
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