Concurrent Review Nurse

The Concurrent Review Nurse position is a critical role within the Utilization Management Department, responsible for assessing the medical appropriateness of requested services. This involves reviewing clinical information and applying evidence-based guidelines to ensure quality care. The nurse will interact with various stakeholders, including providers and members, to gather necessary information and communicate determinations effectively. The role also encompasses managing length of stay, discharge planning, and identifying potential quality of care or safety concerns.