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Concurrent Review Jobs in Georgia (NOW HIRING)

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Concurrent Review information

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 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 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 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 popular job titles related to Concurrent Review jobs in Georgia?

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

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

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

Concurrent Review jobs near you
Infographic showing various Concurrent Review job openings in Georgia as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, 1% Temporary, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution.

Nursing Quality/Stroke & Sepsis Data Analyst- On site

St. Joseph's/Candler

Savannah, GA

$32.26/hr

Full-time

Re-posted 6 days ago

St. Joseph's/Candler Health System rating

7.0

Company rating: 7.0 out of 10

Based on 20 frontline employees who took The Breakroom Quiz

Job description

  • Position Summary
    • Under the direction of the Director of Professional Practice, Specialty Services & Infection Control, the Stroke/Sepsis Data Analyst will abstract, coordinate and manage the internal and external data reporting needs of the Sepsis and Stroke Programs, as well as other disease specific programs as assigned. Will assist Director, Sepsis Coordinator, Stroke Coordinator and CNO with decision support, standardized report preparation, feedback to clinical teams, process improvement teams and stakeholders.
  • Education
    • Bachelors of Nursing - Preferred  (or) Healthcare Sciences - Required
    • Clinical Licensure - Required
    • Masters - Preferred
  • Experience
    • 2-3 Years Health Care Information Technology - Required
    • Quality data management, surveillance, reporting to externally managed databases
  • License & Certification
    • Professional Certification - Required
    • As determined by Education (i.e. nursing license required if applicable to degree)
  • Core Job Functions
    • Manages external databases including Joint Commission, American Heart Association, Coverdell registry by entering required information in a timely manner to meet reporting guidelines and requirements.
    • Daily concurrent reviews for Stroke and Sepsis patients – clinical quality data is abstracted from the medical record and entered into quality format according to established deadlines.  Quality review data is shared with stroke coordinator and sepsis coordinator for validation and dissemination to stakeholders.
    • Participate in quality improvement activities as requested. Works with process improvement teams to analyze performance data and develop PI tools and methodologies to improve patient care (for example:  Door to Needle Times).        
    • Provides concurrent feedback to clinical teams to address potential missed opportunities.
    • 30-day discharge follow up list preparation.
    • Generates reports and graphs for monthly meetings and trending for data reporting to internal and external stakeholders.

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