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California RN Clinical Review Nurse

Company: VirtualVocations
Location: Concord
Posted on: November 14, 2024

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, Concord , California RN Clinical Review Nurse, Healthcare , Concord, California

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