The Concurrent Review Nurse is responsible for performing concurrent reviews in accordance with accepted department criteria, discharge planning, and identifying alternate treatment programs. This role involves conducting episodic case management, consulting, and collaborating with providers, members, and other resources as appropriate. The nurse will assess, plan, and implement options and services required to meet an individual's health needs within the scope of their benefit plan.
Key Responsibilities:
- Perform concurrent reviews in accordance with department criteria.
- Conduct discharge planning and identify alternate treatment programs.
- Engage in episodic case management.
- Consult and collaborate with providers, members, and other resources.
- Assess, plan, and implement options and services to meet health needs within benefit plans.
Job Requirements:
- Registered Nurse (RN) with a current, valid, unrestricted license in the state of operations or reciprocity.
- Three (3) years of clinical experience.
- Experience utilizing various software packages.
- Strong verbal and written communication skills.
- Analytical skills.
- Incumbents with nursing licenses in positions/departments requiring multi-state licenses must obtain and maintain additional current, valid, and unrestricted applicable nursing licenses in other states as determined by management. Multi-state license fees will be provided by HCSC.
- Incumbents with other clinical licenses are not required to obtain multi-state licenses.