Clinical Review Nurse - Concurrent Review

Business Area: Clinical & Care Management Job Type: Full time Position Purpose: 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. Key Details: This role is fully remote/work from home. The role will sup…