Clinical - Concurrent Review Nurse 1

Sunrise, FL 33323

Posted: 08/09/2019 Job Category: Healthcare Support Job Number: 201019

Job Description

Are you an experienced Registered Nurse, LPN, LVN or RN in the state of Florida? Are you looking for a new opportunity to join a workplace where your voice matters? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “ yes” to any of the questions – then the Concurrent Review Nurse is the position for you!

Your day to day responsibilities as Concurrent Review Nurse are:
  • 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

Requirements for the Concurrent Review Nurse Position:
  • Graduate from an Accredited School of Nursing program required
  • Bachelor’ s degree in Nursing preferred
  • MUST have a current state’ s LPN/LVN or RN license in the state of Florida
  • 0-2 years of experience
  • Proficiency operating a Microsoft Windows workstation, 1 year of experience
  • InterQual experience a plus
  • 1 year of working knowledge of medical terminology
  • MUST have working knowledge of case management
  • MUST have Utilization Management, Case Management, or Planning Discharge experience, 1 year

Job Details:
  • Fulltime, M-F, 40 hours a week
  • Flexibility in schedule a must
  • Contract assignment, 12 months, possible extension
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