Remote Clinical Review Nurse - Concurrent Care (CA)

IMCS Group; United States; Remote; USD 48,216 - 59,236; Full time

Job summary

A healthcare organization is seeking a Clinical Review Nurse – Concurrent Review to perform utilization management functions remotely. The role requires conducting concurrent reviews, collaborating with medical teams, and ensuring quality healthcare outcomes. Candidates should have an ADN or BSN and 2–4 years of experience, particularly in concurrent review and InterQual. Strong communication, attention to detail, and proficiency in Microsoft Office tools are essential. This position offers the opportunity to be part of a supportive and collaborative team.

Qualifications

• 2–4 years of related experience, including concurrent review and InterQual.
• Preferred TruCare experience.
• Proficiency in InterQual and Microsoft Office tools.

Responsibilities

• Conduct concurrent reviews of member care and discharge plans.
• Collaborate with providers and medical directors for appropriate care.
• Provide subject matter expertise to utilization management teams.

Skills

Strong communication

Detail-oriented

Tech-savvy

Education

ADN or BSN; Graduate from an accredited school of nursing

Tools

InterQual

Microsoft OneNote

Microsoft Word

Microsoft Excel

Microsoft Teams

Job description

A healthcare organization is seeking a Clinical Review Nurse – Concurrent Review to perform utilization management functions remotely. The role requires conducting concurrent reviews, collaborating with medical teams, and ensuring quality healthcare outcomes. Candidates should have an ADN or BSN and 2–4 years of experience, particularly in concurrent review and InterQual. Strong communication, attention to detail, and proficiency in Microsoft Office tools are essential. This position offers the opportunity to be part of a supportive and collaborative team.