ZipRecruiter

Log In

1

Concurrent Review Jobs in California (NOW HIRING)

Talent Software Services

Nurse RN 5

Roseville, CA · On-site

Prior work history of post service, prior auth, concurrent review. Preferential interview consideration for post service experience. * Lives in California Disqualifiers/Dislikes On Resumes:

previous pagenext page

Showing results 21-40

All JobsConcurrent Review JobsConcurrent Review Jobs in California

Concurrent Review information

See California salary details

$15

$31

$52

How much do concurrent review jobs pay per hour?

As of Aug 23, 2026, the average hourly pay for concurrent review in California is $31.52, according to ZipRecruiter salary data. Most workers in this role earn between $22.07 and $40.10 per hour, depending on experience, location, and employer.

What is concurrent review in healthcare?

Concurrent review is a process used in healthcare to assess the necessity and appropriateness of ongoing inpatient care while the patient is still hospitalized. The goal is to ensure that medical services are being delivered efficiently and according to established guidelines. Utilization review nurses or case managers typically conduct these reviews by evaluating medical records, communicating with providers, and making recommendations regarding continued stay or discharge planning. This helps control healthcare costs and improves patient outcomes by preventing unnecessary treatments or extended hospitalizations.

What are some common challenges faced by concurrent review nurses, and how can they be managed?

Concurrent Review nurses often face challenges such as managing a high volume of case reviews within tight deadlines and ensuring timely communication with providers and insurance companies. Staying organized, utilizing efficient documentation systems, and maintaining up-to-date knowledge of regulatory requirements can help overcome these hurdles. Collaboration with interdisciplinary teams and regular training on evolving guidelines are also essential for success in this role.

What are the key skills and qualifications needed to thrive as a concurrent review nurse, and why are they important?

To thrive as a Concurrent Review Nurse, you need a strong clinical background, current RN licensure, and a thorough understanding of utilization management and healthcare regulations. Familiarity with case management software, electronic health records (EHRs), and knowledge of insurance guidelines and ICD/CPT coding is typically required. Excellent analytical thinking, communication skills, and attention to detail help in collaborating with providers and ensuring appropriate care. These competencies are crucial for ensuring patients receive medically necessary care while maintaining compliance and cost-effectiveness.

What is the difference between Concurrent Review vs Utilization Review?

AspectConcurrent ReviewUtilization Review
PurposeAssess ongoing patient care during hospitalizationEvaluate the necessity and appropriateness of services, often before or after care
TimingPerformed in real-time during treatmentCan be pre-authorization, concurrent, or retrospective
Work EnvironmentHospitals, clinics, insurance companiesInsurance companies, healthcare organizations
CredentialsRegistered nurses, case managers, healthcare professionalsMedical reviewers, nurses, case managers

Concurrent Review focuses on evaluating ongoing patient care during hospitalization, ensuring treatments are appropriate in real-time. Utilization Review has a broader scope, including pre-authorization and retrospective assessments to determine the necessity of services. While both roles involve healthcare professionals and are used within insurance and healthcare settings, their timing and specific focus differ.

What are popular job titles related to Concurrent Review jobs in California?

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

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

The top searched job categories for Concurrent Review jobs in California are:

Concurrent Review jobs near you
Infographic showing various Concurrent Review job openings in California as of August 2026, with employment types broken down into 1% As Needed, 86% Full Time, 10% Part Time, 2% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $65,566 per year, or $31.5 per hour.

Utilization Review RN (Hybrid)

Vivo HealthStaff

Oakland, CA • On-site

Full-time

Re-posted 12 days ago

Job description

Vivo HealthStaff is searching for a Utilization Review RN for a hybrid position for a health plan in San Francisco. It is a hybrid position with 1-2 days per week on-site required.Collaborates with the physician, nurse case manager, social worker, and other members of the health care team to meet individualized patient outcomes. Performs concurrent, and retrospective medical record reviews based on approved screening criteria, knowledge of insurance coverage, and communication with the third-party payers. Ensures medical necessity determinations, service authorization and concurrent denials are managed effectively and financially responsibly.EducationValid RN license in State of CaliforniaBachelor's degree in NursingExperienceClinical experience in acute care setting RequiredExperience with interqual and millimen PreferredLicenses and CertificationsCPR - Cardiac Pulmonary Resuscitation CPR/BLS Preferred andCCM - Certified Case Manager CCM Preferred andACMA PreferredKnowledge, Skills, and AbilitiesVerbal and written communication skills.Basic computer skills.Diagnostic and problem-solving skills.Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards, and safety standards. Complies with governmental and accreditation regulations.Actively participates in ongoing professional enrichment and educational opportunities. Collaborates with and assists the nurse case manager and social worker to meet the patients' continuing health needs in a high quality, cost effective manner. Participates in planning rounds as needed to address and communicate issues related to acuity level of patient, LOS insurance and discharge needs.Collects quality improvement data in accordance with approved indicators. Recognizes potential problems and makes referrals to quality improvement, risk management, safety, infection control, and other departments as appropriate.Confers and collaborates routinely with the physician advisor, division chiefs, and attending physicians to resolve problems regarding acuity and level of care.Evaluates concurrent and retrospective denials for appeal opportunities. May generate appeal letters based on knowledge of clinical severity and intensity.Identifies insurance information, obtains authorization, communicates with financial counseling and assigns appropriate length of stay for admission.Implements strategies to avoid denials including potential denial notification to attending physician. Issues letter of non-coverage for Medicare or third party payers according to policies and procedures. Communicates utilization plans to case management team.Performs admission reviews and subsequent concurrent reviews to determine the necessity for acute care by application of accepted criteria based on age specific needs. Interacts with and assists third party payer reviewers to facilitate appropriate care and ensure payment for services. Performs concurrent and retrospective reviews telephonically as required. Completes all forms and documentation necessary to support appropriate utilization of resources.Serves as a resource to all staff in areas of utilization review/management. Educates members of health care team through in-services, staff meetings, orientation and formal educational offerings.Demonstrates knowledge of the dynamics of abuse/neglect, including identification and reporting laws. Coordinates with investigating law enforcement, protection agencies, hospital security, risk management, and healthcare team. Demonstrates knowledge of community resources serving the high social risk populations.Performs other duties as assigned.
Vivo HealthStaff logo

About Vivo HealthStaff

Sourced by ZipRecruiter

Vivo HealthStaff provides permanent recruitment services for both clinical and administrative positions in the healthcare sector. Over the past 2 years, our clients have seen a 98% retention rate with Vivo HealthStaff placements.

Industry

Health care and social assistance

Company size

11 - 50 Employees

Headquarters location

Dublin, CA, US

Year founded

2016

Social media

FacebookTwitter

View All Vivo HealthStaff Jobs