California RN Clinical Review Nurse
Company: VirtualVocations
Location: Concord
Posted on: November 14, 2024
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Job Description:
A company is looking for a Clinical Review Nurse - Retrospective
Review.
Key Responsibilities
Perform clinical retrospective reviews of services to assess
appropriateness and compliance
Review medical records for necessity and quality of care, referring
issues to the Medical Director as needed
Document and maintain member clinical information to ensure
regulatory compliance
Required Qualifications
Graduate from an Accredited School of Nursing or Bachelor's degree
in Nursing
2 - 4 years of related experience
Clinical knowledge to analyze medical records for appropriate care
services
Knowledge of Medicare and Medicaid regulations preferred
RN license required for Health Net of California
Keywords: VirtualVocations, Walnut Creek , California RN Clinical Review Nurse, Healthcare , Concord, California
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