Clinical Review Nurse - Concurrent Review

Remote-ILremote$56K$101K

Posted today · via Workday

About this role

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 position is remote/work from home and will support Illinois Medicaid and Ambetter utilization management. The position requires an Illinois RN licensure. The role is full-time, work hours are Monday - Friday, 8am - 5pm central time zone, and rotating weekends and holidays.…

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What we'd score you on

reqspace match rubric

Five dimensions, recruiter-grade. Upload your resume and we'll generate a written explanation of where you fit and where the gaps are.

1

Skills match

For this role: monday

2

Level fit

We check your title trajectory against the seniority signal of the role.

3

Domain experience

Your work in the role's domain matters more than your years total. We weight recent and direct experience.

4

Recency

A skill you used last quarter weighs more than one from five years ago. We grade on recency, not lifetime.

5

Location fit

This role is remote-eligible — we factor in your stated location and time-zone overlap.

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Skills in this role

Pulled from the job description. These are the keywords we'll weight when scoring your fit.

monday

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