Harrisburg, PA

Concurrent Review Nurse

Capital BlueCross seeks a Concurrent Review Nurse to evaluate  

targeted inpatient members to determine appropriateness of level of  

care and treatment; monitor progression of care to determine  

appropriate level of care/treatment with emphasis on promoting  

quality care/cost effective outcomes; and coordinate services for  

members by working in conjunction with external/internal consulting  

treatment team to establish effective discharge plan within benefit  

structure.

Requires a PA licensed RN with 5-7 years of clinical nurse  

experience working in acute care hospital; 3-5 years of utilization  

review/ discharge planning experience; PC skills, including Microsoft  

Word/Access proficiency; ability to demonstrate openness,  

flexibility, problem solving, patience, and tact; plus a valid PA  

driver’s license and ability to travel using own vehicle.  Knowledge  

of Act 68/ NCQA/ERISA/CMS regulations as well as managed care  

principles/emerging health treatment modalities is necessary.  Two  

years of managed care experience preferred.

Excellent compensation/benefits offered.  

Send resume to:  human.resources@capbluecross.com

Capital BlueCross

Staffing 

Harrisburg, PA 17177-2211 

www.capbluecross.com  

EOE/AA.