ZipRecruiter

Log In

1

Concurrent Review Nurse Jobs (NOW HIRING)

Houston Healthcare

$80 - $100/hr

Work Shift The Utilization Reviewer performs concurrent, extended stay and retrospective reviews of ... Graduate of an accredited School of Nursing. * Experience: Three (3) years in an acute care setting.

Medix

SNF Review Nurse (LVN or RN)

Orange, CA · On-site

$38 - $51/hr

Conduct daily inpatient and concurrent reviews and coordinate appropriate levels of care. * Coordinate care and placements for: * Durable Medical Equipment (DME) * Home Health (HH) * Skilled Nursing ...

HandsOn Global Management

Be Seen First

UM Review Nurse

Tampa, FL · Remote

$36 - $40/hr

Performs prospective, concurrent, and retrospective inpatient and/or outpatient utilization reviews ... Licensed RN or LPN required. * Minimum of two to three years varied clinical experience required.

AbsoluteCare

Utilization Review Nurse

New Orleans, LA · On-site

The Utilization Review Nurse ensures appropriate utilization of health services by performing initial, concurrent and retrospective clinical case reviews. This role collaborates and communicates with ...

previous page

Showing results 41-60

All JobsHealthcare JobsNursing JobsUtilization Review Nurse JobsConcurrent Review Nurse Jobs

Concurrent Review Nurse information

See salary details

$21

$42

$68

How much do concurrent review nurse jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for concurrent review nurse in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What is a concurrent review nurse?

A Concurrent Review Nurse is a healthcare professional responsible for evaluating patient care and treatment plans in real time to ensure they meet medical necessity and insurance guidelines. They work with healthcare providers and insurance companies to review hospital stays, procedures, and treatments while patients are still receiving care. Their goal is to ensure appropriate resource utilization, prevent unnecessary costs, and support positive patient outcomes. These nurses must have strong clinical knowledge, critical thinking skills, and familiarity with insurance policies and regulations. They often collaborate with case managers, physicians, and insurance representatives to coordinate care efficiently.

What are the typical daily responsibilities of a concurrent review nurse?

A Concurrent Review Nurse is responsible for reviewing patient admissions and ongoing hospital stays to ensure medical necessity and adherence to insurance guidelines. Daily tasks often include analyzing clinical documentation, communicating with treating physicians, and coordinating with case managers and insurance representatives. You may also need to document findings in electronic health records and help facilitate timely transitions of care or discharge planning. This role requires regular collaboration with both clinical teams and administrative staff to support quality patient outcomes and efficient healthcare delivery.

What are the key skills and qualifications needed to thrive in the concurrent review nurse position?

To thrive as a Concurrent Review Nurse, you need strong clinical assessment skills, a current RN license, and a good understanding of healthcare regulations and utilization management. Proficiency with case management systems, electronic health records (EHRs), and familiarity with Medicare/Medicaid guidelines are highly valued. Excellent attention to detail, critical thinking, and effective communication skills help you succeed in fast-paced, multidisciplinary settings. These abilities are vital for ensuring appropriate care delivery, meeting compliance standards, and facilitating collaboration between healthcare providers and insurance companies.

More about Concurrent Review Nurse jobs

What cities are hiring for Concurrent Review Nurse jobs?

Cities with the most Concurrent Review Nurse job openings:

What are the most commonly searched types of Concurrent Review Nurse jobs?

The most popular types of Concurrent Review Nurse jobs are:

What states have the most Concurrent Review Nurse jobs?

States with the most job openings for Concurrent Review Nurse jobs include:

What job categories do people searching Concurrent Review Nurse jobs look for?

The top searched job categories for Concurrent Review Nurse jobs are:

What are popular job titles related to Concurrent Review Nurse jobs?

For Concurrent Review Nurse jobs, the most frequently searched job titles are:

Concurrent Review Nurse jobs near you
Infographic showing various Concurrent Review Nurse job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 1% Temporary, and 3% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.

Concurrent Nurse Reviewer - Facility Utilization Review Unit

Hawaii Medical Service Association

Honolulu, HI • Hybrid

Full-time

Re-posted 11 days ago

Job description

  1. Applies appropriate medical necessity criteria from established medical policies and clinical practice guidelines to apply concurrent review determinations as described in the Medical Management UM work plan.
    • This detailed clinical judgment includes determination of inpatient hospital stays as medically appropriate for the member's clinical condition or whether the stay requires referral to a Medical Director for potential denial.
    • The Nurse Reviewer must follow each line of business requirements and each accrediting body's (CMS, NCQA, HSAG) requirements for each inpatient admission.
    • Responsibilities include using effective relationship management, coordination of services, resource management, education, patient advocacy, and related interventions to:
      • Promote improved quality of care and/or life
      • Promote cost effective medical outcomes
      • Prevent hospitalization when possible and appropriate
      • Promote decreased lengths of hospital stays when appropriate
      • Ensure the quality-of-care member is receiving during hospital stay is appropriate
      • Ensure appropriate levels of care are received by patients
      • Consult with Medical Directors on potential quality issues encountered during review of medical records in situations when the complexity of the member's medical, surgical and/or pharmaceutical management is unclear and may require further review or intervention and follow up with attending physicians, hospitalists, or other facility staff
  2. Provide appropriate consultation and referral to Case Management or QUEST Integration program as appropriate
  3. Identify appropriate alternative and non-traditional resources and demonstrate creativity in managing each case to fully utilize all available inpatient and community resources.
  4. Identifies cost savings and accurately records all communications and interventions.
  5. Evaluates suspended claims against medical records to determine the medical necessity and appropriateness of medical services, identify irregularities such as over or under-utilization of services, potential up-coding, over billing, etc.
  6. Communicates timely, accurate information either verbally or in writing using clinical judgment, knowledge of medical/reimbursement policies and plan benefits to internal MM staff, other internal departments (Claims Administration, Customer Relations, etc.), providers, members, and other authorized persons.
    • For denied services, ensures the denial, benefit and appeal language are accurate and consistent with department procedures, accreditation, and regulatory guidelines.
  7. Identifies and refers members with specific medical and/or behavioral health needs or complex case management and collaborates with case management staff as needed. Also identifies and refers quality of care issues and suspected fraud, waste, or abuse to the appropriate departments.
  8. Performs all other miscellaneous responsibilities and duties as assigned or directed.
#LI-Hybrid
  1. Associates Degree in Nursing
  2. Two years clinical care experience or case management; or related experience.
  3. Knowledge of the appropriate protocol to be followed for a given diagnosis and the normative values of medical tests and procedures.
  4. Good typing skills: Typing speed of 40 wpm
  5. Strong organizational skills
  6. Good communication skills: verbal and written
  7. Basic working knowledge of Microsoft Office applications. Including but not limited to Word, Excel, and Outlook.
  8. Currently licensed in Hawaii as an RN or LPN
    • (if applicable upon hire, proof of licensure to be provided by employee or confirmed by Human Resources)

Apply