Position Title: Clinical Review Nurse - Concurrent Review
Work Location: Remote – CT, ET, MT (CT preferred)
Assignment Duration: 6 Months - Possible extension
Work Schedule: Mon – Fri | 8am – 5pm CST
OT needs approval (not required)
Possible Holiday (needs approval and not required) | Rotational weekend shifts
Work Arrangement: Remote

Position Summary:
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 Responsibilities:

• Review clinical charts for medical necessity for inpatient admissions
• Review concurrently as long as they remain in-house/inpatient until discharged
• Utilize InterQual to review medical necessities
• Make appropriate referrals for members depending on their clinical presentation
• No direct communication to members
• Participation in rounds

Qualification & Experience:

Candidate Requirements
Education/Certification	Required: Graduate from an Accredited School of Nursing or Bachelor’s degree in Nursing and 2-4 years of related experience			Preferred:
Licensure	Required: Registered Nurse or LPN License			Preferred: Registered Nurse License - compact
Years of experience required: Requires at least two years of Acute Care or ICU care experience.   Disqualifiers: No Acute Care or ICU care experience   Additional qualities to look for: adaptable, flexible, good time management skills, team player
Top 3 must-have hard skills stack-ranked by importance		1	Minimum of 2 years of Acute or ICU clinical experience
		2	Organizes and prioritizes effectively
		3	Problem-solving skills

 
 
At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws.This position's pay range is $37.00/hr - $40.00/hr.