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Hourly Concurrent Review Nurse Jobs (NOW HIRING)

Leon Medical Centers

Concurrent Review Nurse

Miami, FL · On-site

Concurrent Review Nurse Under the general supervision of the Director of Health Services, the Concurrent Review Nurse is responsible for ensuring the delivery of medically necessary, high-quality ...

Leon Health, Inc.

Concurrent Review Nurse

Miami, FL · On-site

Under the general supervision of the Director of Health Services, the Concurrent Review Nurse is responsible for ensuring the delivery of medically necessary, high-quality, and cost-effective care.

Leon Medical Centers

Concurrent Review Nurse

Doral, FL · On-site

Under the general supervision of the Director of Health Services, the Concurrent Review Nurse is responsible for ensuring the delivery of medically necessary, high-quality, and cost-effective care.

Leon Health Plan

Concurrent Review Nurse

Doral, FL

Under the general supervision of the Director of Health Services, the Concurrent Review Nurse is responsible for ensuring the delivery of medically necessary, high-quality, and cost-effective care.

Leon Health, Inc.

Concurrent Review Nurse

Doral, FL · On-site

Under the general supervision of the Director of Health Services, the Concurrent Review Nurse is responsible for ensuring the delivery of medically necessary, high-quality, and cost-effective care.

iPlace USA

Concurrent Review Nurse

Bedford, NH · On-site

Perform onsite review of emergent/urgent and continued stay requests Qualifications * 2+ years of clinical nursing experience in an acute care. * Current state's RN license. Additional Information ...

iPlace USA

Concurrent Review Nurse

Bedford, NH · On-site

Perform onsite review of emergent/urgent and continued stay requests Qualifications * 2+ years of clinical nursing experience in an acute care. * Current state's RN license. Additional Information ...

HealthHelp

Nurse, Concurrent Review

$75K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Nurse, Concurrent Review Performs concurrent inpatient utilization review using InterQual criteria to determine if the request meets medical necessity criteria, including admission reviews, continued ...

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WNS Global Services

Nurse, Concurrent Review

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... Performs concurrent inpatient utilization review using InterQual criteria to determine if the ... Nursing Facility, Inpatient Rehabilitation Facility, Long-Term Acute Care Hospital) • Related ...

WNS

Nurse, Concurrent Review

$75K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Nurse, Concurrent Review Performs concurrent inpatient utilization review using InterQual criteria to determine if the request meets medical necessity criteria, including admission reviews, continued ...

WNS Global Services

Nurse, Concurrent Review

Houston, TX · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Performs concurrent inpatient utilization review using InterQual criteria to determine if the ... Admission reviews Continued stay reviews Transitional care reviews (Skilled Nursing Facility ...

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Hourly Concurrent Review Nurse information

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How much do hourly concurrent review nurse jobs pay per hour?

As of Aug 20, 2026, the average hourly pay for hourly 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 the difference between Hourly Concurrent Review Nurse vs Utilization Review Nurse?

AspectHourly Concurrent Review NurseUtilization Review Nurse
CertificationsRN license, possibly certifications in case management or utilization reviewRN license, certifications in case management or utilization review
Work EnvironmentHospitals, insurance companies, healthcare facilitiesInsurance companies, healthcare organizations, managed care
Job FocusReal-time review of patient care during hospitalizationAssessment of medical necessity for services, prior or concurrent review

Both roles require RN licensure and similar certifications, with overlapping work environments in healthcare and insurance sectors. The main difference is that the Hourly Concurrent Review Nurse focuses on real-time, in-hospital patient care reviews, while the Utilization Review Nurse often handles broader assessments of medical necessity, including prior authorizations. Understanding these distinctions helps professionals and employers align job expectations and career paths effectively.

What cities are hiring for Hourly Concurrent Review Nurse jobs?

Cities with the most Hourly 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 Hourly Concurrent Review Nurse jobs?

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

Hourly Concurrent Review Nurse jobs near you

Concurrent Review Nurse

Leon Medical Centers

Miami, FL • On-site

Other

Posted 7 days ago

Job description

Concurrent Review Nurse

Under the general supervision of the Director of Health Services, the Concurrent Review Nurse is responsible for ensuring the delivery of medically necessary, high-quality, and cost-effective care. This is achieved through the review of inpatient admissions, outpatient precertification, and prior authorization requests, using established medical policies, evidence-based guidelines, and managed care standards.

Essential Duties and Responsibilities
  • Lead, train, and support both clinical and non-clinical staff in accordance with Leon Health's policies and procedures to ensure efficient and effective performance.
  • Monitor and respond to incoming calls and written inquiries from members, providers, and internal departments.
  • Oversee the quality, accuracy, and timeliness of prior authorization reviews and ensure appropriate prioritization.
  • Enter service requests and determination data into the appropriate systems in compliance with regulatory requirements and organizational policies.
  • Review clinical documentation for precertification and concurrent (ongoing) reviews.
  • Perform on-site and/or telephonic reviews to determine the appropriateness of inpatient and outpatient care settings, using medical policies, CMS guidelines, and industry standards.
  • Conduct medical and behavioral health (BH) reviews for pre- and post-service authorization requests.
  • Issue authorizations for inpatient admissions, outpatient services, and post-service requests to providers, facilities, and members as applicable.
  • Refer complex cases to a Medical Director or Behavioral Health Practitioner when additional clinical evaluation is required.
  • Ensure all documentation is complete, accurate, and clearly supports authorization decisions.
  • Process denial determinations in compliance with regulatory standards and internal policies.
  • Maintain up-to-date census reports, daily notes, and authorization records, including tracking admissions and discharges.
  • Collaborate with healthcare providers to obtain necessary clinical documentation for medical necessity determinations.
  • Work with providers to proactively identify discharge needs and assist in care planning.
  • Facilitate smooth care transitions across the healthcare continuum by coordinating with facilities and the Care Management team.
Education
  • Bachelor's degree in Nursing required
Experience
  • Minimum of two (2) years of experience in clinical review or utilization management
Language Skills
  • Bilingual in English and Spanish (required)

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