Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Clinical Medical Review Nurse

Lumen Solutions Group Inc.

Clinical Medical Review Nurse

We are seeking Licensed Practical Nurses (LPN) or Registered Nurses (RN) to join the Quality team as Clinical Medical Review Nurses. This is a hybrid contract position requiring both remote work and regular onsite presence at the Canton, MD office. Nurses will support the review and abstraction of medical records to ensure accuracy and compliance with quality standards.

Key Responsibilities:

  • Review and abstract data from medical records
  • Extract relevant clinical data using Electronic Medical Record (EMR) systems
  • Participate in periodic onsite provider visits (minimum once per month) to retrieve medical records
  • Attend mandatory in-person training in January and again in June or July
  • Use basic Excel to enter, track, and manage clinical data
  • Work collaboratively with internal QA and clinical teams

Qualifications:

  • Active RN, LPN, or Compact Nursing License (must be current and in good standing)
  • Minimum 5 years of clinical experience
  • Experience with medical record review and data abstraction
  • Proficiency with Electronic Medical Record (EMR) systems
  • Basic knowledge of Microsoft Excel
  • Must reside in the state of Maryland (MD)
  • Willingness to be onsite 2–3 days/week in Canton, MD and travel to provider offices as needed

Preferred Qualifications:

  • HEDIS experience (preferred but not required)
  • Nursing degree (Associate or Bachelor's – a plus)
Vacancy posted 5 days ago
Similar jobs that could be interesting for youBased on the Clinical Medical Review Nurse in Baltimore, MD vacancy
  • $36.49 - $41.49 per hour

     ...Pay Range: $36.49hr - $41.49hr Job Overview: The Clinical Medical Review Nurse handles day to day review of professional and institutional claims and provider appeals that require medical review to determine if the claim is eligible for benefits and to... 
    Medical
    Work at office
    Remote work

    Cynet Systems

    Baltimore, MD
    5 days ago
  •  ...Clinical Medical Review Nurse Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are in search of a highly motivated candidate to join our talented team. The Contingent RN supports CareFirst by analyzing... 
    Medical
    Remote work

    Ampcus

    Owings Mills, MD
    4 days ago
  • $36.49 - $41.49 per hour

     ...49hr - $41.49hr Responsibilities Review, research, and analyze professional and institutional claims using clinical judgment and medical policies for accurate adjudication....  ...Participate in medical policy meetings, nursing forums, and review sessions with medical... 
    Medical
    Work at office

    Cynet Systems

    Baltimore, MD
    1 day ago
  •  ...Clinical Medical Review Nurse The Clinical Medical Review Nurse handles day to day review of professional and institutional claims and provider appeals that require medical review to determine if the claim is eligible for benefits and to support claims processing and... 
    Medical
    Work at office
    Remote work

    TalTeam

    Baltimore, MD
    2 days ago
  • $39.35 - $54.05 per hour

     ...Experienced Registered Nurse Experienced Registered Nurse position...  ...at the University of Maryland Medical Center Midtown Campus. The...  ...primarily based in an outpatient clinic, the nurse may occasionally...  ...development of unit based peer review processes; actively participates... 
    Medical
    Full time
    Work experience placement
    Shift work

    University of Maryland Medical Center

    Baltimore, MD
    4 days ago
  •  ...Advocate for appropriate care by reviewing admissions and service...  ...receives the right level of medical necessity at the right time....  ...in even the most challenging clinical situations. Support the frontline...  ...Certification / Registration: Registered Nurse credentialed from the... 
    Medical
    Full time
    Local area
    Remote work
    Monday to Friday
    Weekend work
    Day shift

    Ascension

    Baltimore, MD
    3 days ago
  • $1,464 - $1,559 per week

     ...Registered Nurse (RN) | Utilization Review Location: Baltimore, MD Agency: GQR Healthcare Pay: $1,464 to $1,559 per week Shift...  ...assignment. Benefits: ~ Day 1 Insurance ~ Cigna medical, MetLife dental and vision insurance ~ License reimbursement... 
    Medical
    Hourly pay
    Weekly pay
    Full time
    Contract work
    Immediate start
    Shift work

    GQR Healthcare

    Baltimore, MD
    1 day ago
  • $1,464 - $1,559 per week

     ...Registered Nurse (RN) | Utilization Review Location: Baltimore, MD Agency: GQR Healthcare Pay: $1,464 to $1,559 per week Shift...  ...assignment. Benefits: ~ Day 1 Insurance ~ Cigna medical, MetLife dental and vision insurance ~ License reimbursement... 
    Medical
    Hourly pay
    Weekly pay
    Full time
    Contract work
    Immediate start
    Shift work

    TravelNurseSource

    Baltimore, MD
    1 day ago
  • $40.12 - $62.19 per hour

     ...Sunday role Summary: The Utilization Review Nurse RN conducts initial, concurrent and retrospective chart review for clinical, financial and resource utilization...  ...Responsibilities Include: Reviews the medical record by applying utilization review criteria... 
    Medical
    Weekend work

    LifeBridge Health, Inc.

    Randallstown, MD
    a month ago
  • $2,011 per week

     ...Registered Nurse (RN) | Progressive Care Unit Location: Baltimore, MD...  ...provide care for patients with complex medical needs. Strong experience in...  ...proceeding without an interview. All clinical submissions will undergo a thorough review. Complete compliance with... 
    Medical
    Full time
    Contract work
    Shift work
    Weekend work

    Cynet Health

    Baltimore, MD
    1 day ago
  • $1,989 - $2,142 per week

     ...Registered Nurse (RN) | Progressive Care Unit Location: Baltimore...  ...by MIT Sloan Management Review. No matter if you want to explore...  ...healthcare system · Day-1 medical benefits that last up to 30...  ...6 months · 24/7 support · Clinical support throughout your assignment... 
    Medical
    Full time
    Contract work
    Local area
    Immediate start
    Shift work

    TravelNurseSource

    Baltimore, MD
    1 day ago
  • $2,076 - $2,229 per week

     ...Registered Nurse (RN) | Home Health Location: Owings Mills, MD...  ...Satisfaction by MIT Sloan Management Review. No matter if you want to...  ...healthcare system · Day-1 medical benefits that last up to 30...  ...6 months · 24/7 support · Clinical support throughout your assignment... 
    Medical
    Full time
    Contract work
    Local area
    Immediate start
    Shift work

    TravelNurseSource

    Owings Mills, MD
    1 day ago
  •  ...Description Job Description Clinical Supervisor (RN) - Weekends Only Join the Holly Hill Nursing and Rehab Center Team! We...  ...Nursing, Rehabilitation, and Medical Services to ensure seamless care...  ...documentation and staff performance reviews • Participate in quality... 
    Medical
    Local area
    Weekend work

    Holly Hill Nursing and Rehab Center

    Towson, MD
    a month ago
  • $37.15 - $57.58 per hour

     ...Registered Nurse (RN) - Wound Care / Long-Term Care Levindale,...  ...Wound Care experience to join our clinical team. Under the direction of...  ...initiatives and peer review activities. Maintain current...  ...On Experience Benefits: Medical, dental, and vision coverage starting... 
    Medical
    Hourly pay
    Relief
    Day shift

    LifeBridge Health, Inc.

    Baltimore, MD
    3 days ago
  •  ...rating only reached by 19% of nursing homes in the country. Keswick...  ...Pilates What will I do as a Clinical Resource Nurse with Keswick?...  ...assessments and documentation. Review admission paperwork for...  ...physician orders, and ensure medication reconciliation. Manage resident... 
    Medical
    Full time
    Temporary work

    Keswick

    Baltimore, MD
    2 days ago
  • $37 - $54.18 per hour

     ...practices with solid knowledge and clinical skills; engaged in advancing...  ...Licensure as a Registered Nurse in the state of Maryland, or eligible...  ...(if applicable): Review the 2025-2026 UMMS Benefits Guide...  ...according to EEO guidelines. University of Maryland Medical Center
    Medical
    Day shift

    University of Maryland Medical Center

    Towson, MD
    1 day ago
  • $37.75 - $52 per hour

     ...to the University of Maryland St. Joseph Medical Center, you're coming to more than simply...  ...independently practices with solid knowledge and clinical skills; engaged in advancing own practice...  ...: Pay Range: $37.75 -$52.00 Review the 2025-2026 UMMS Benefits Guide University... 
    Medical
    Night shift

    University of Maryland Medical Center

    Towson, MD
    1 day ago
  • $39.35 - $54.05 per hour

     ...and licensed experience. The nurse will utilize this time to learn...  ...Mission, Vision and Values. Clinical Practice/Care Delivery 1....  ...6. Provides feedback in peer review as requested. Work Experience...  ...post first day of employment. University of Maryland Medical Center
    Medical
    Work experience placement
    Relocation package
    Flexible hours

    University of Maryland Medical Center

    Towson, MD
    5 days ago
  • $83.72k - $136.13k

     ...Clinical Administrator The Clinical Administrator is a member of...  ...Health entity-based Division of Nursing and leadership team. The role...  ...as well as senior medical staff and other Nurse Leaders...  ...communication with leaders to review programs provide feedback discuss... 
    Medical
    Daily paid
    Shift work
    Night shift
    Weekend work
    Afternoon shift

    IntelyCare

    Brooklyn, MD
    1 day ago
  • $39.35 - $54.05 per hour

     ...Registered Nurse (RN), Stroke, Day Shift 7a-7p The following statements...  ...personnel so classified. Clinical Practice: 1. Provides...  ...development; leads unit based peer review processes. 3. Actively...  ...contact us at ****@*****.***. University of Maryland Medical Center
    Medical
    Work experience placement
    Day shift

    University of Maryland Medical Center

    Baltimore, MD
    2 days ago
  •  ...compassionate, skilled, and motivated Clinical Nurse II to join our Inpatient Spinal Cord...  ...patient safety data, including handoffs, medication safety, and other nursing quality...  ...growth opportunities. Support peer review processes and actively engage in providing... 
    Medical
    Work experience placement

    University of Maryland Medical Center

    Baltimore, MD
    21 hours ago
  • $64.6k - $113.3k

     ...Clinical Nurse We are seeking a Clinical Nurse who will support the Outpatient Parenteral Antimicrobial...  ...Hospital and Johns Hopkins Bayview Medical Center, including providing support and,...  ...directed from office support staff, lab review, coordination of home care, and... 
    Medical
    Full time
    Work at office

    Johns Hopkins University

    Lutherville Timonium, MD
    5 days ago
  • $38.05 - $57.05 per hour

     ...adapt and manage his or her medical situation in the comfort of their...  ...for Home Health Registered Nurses (RN) to join their growing...  ...ResponsibilitiesUnder the direction of the clinical manager, the Home Health...  ...-up visits and phone calls. Reviews chart for completeness and... 
    Medical
    Monday to Friday

    Mercy Medical Center

    Lutherville Timonium, MD
    5 days ago
  • $44 - $49 per hour

     ...seeking a self-motivated, team-oriented nurse with strong clinical skills and strong critical care skills...  ...our Team! We offer Competitive Pay, Medical, Dental and Vision Plans Must...  ...laws. For further information, please review the Know Your Rights notice from the Department... 
    Medical
    Hourly pay
    Full time
    Monday to Friday

    Ambulatory Surgery Center

    Towson, MD
    3 days ago
  • $1,870 per week

     ...Registered Nurse (RN) - Progressive Care/Stepdown (PCU)Location:...  ...item is an Engagement Letter review completed with your recruiter...  ...one. We include several major medical plan options. Our premium plans...  ...Hancock with employer matching.24/7 Clinical Support: Healthcare... 
    Medical
    Full time
    Contract work
    Immediate start
    Flexible hours
    Shift work

    Travel Nurses Inc

    Baltimore, MD
    1 day ago
  • $40 - $50 per hour

     ...Home Infusion Registered Nurse (PRN)At CSI Pharmacy (CSI), we are...  ...technical, clerical, and clinical task associated with patient...  ..., and infusion of injectable medications. In addition, performs designated...  ...by the Ig educator, including review of educational materials,... 
    Medical
    Relief
    Local area
    Immediate start

    CSI Pharmacy

    Baltimore, MD
    4 days ago
  • $45 - $50 per hour

     ...Description Position Title: Delegating Nurse Salary: $45.00-$50.00/hour (Based...  ...for the overall supervision and clinical oversight of resident care in the assisted...  ...accuracy and completeness of the medical record. 4. Reviews the Assisted Livings Manager's... 
    Medical
    Part time
    Flexible hours
    Shift work
    Weekend work

    Blakehurst

    Towson, MD
    4 days ago
  •  ...Nurse Leader Position The University of Maryland Medical Center is at the vital core of Maryland's health care system and...  ...designed for the nurse who is a clinical and professional leader at the unit...  ...; leads unit-based peer review processes. 2. Actively engaged... 
    Medical
    Work experience placement

    University of Maryland Medical Center

    Baltimore, MD
    1 day ago
  •  ...Independent Contractor Registered Nurse Attention all Registered...  ...services to meet the medical and dental requirements to maintain...  ...Assessments of military personnel. Review health history, service member...  ...Minimum of 2 years of recent clinical experience as a Registered... 
    Medical
    For contractors
    Local area
    Immediate start
    Weekend work
    Weekday work

    DOCS Health

    Baltimore, MD
    5 days ago
  • $2,444 per month

     ...Details Client Name JHHS - Bayview Medical Center Job Type Travel Offering Nursing Profession RN Specialty Clinic Job ID 19191678 Job Title RN - Clinic Weekly Pay $2444.0... 
    Medical
    Weekly pay
    Local area
    Shift work

    JHHS - Bayview Medical Center

    Baltimore, MD
    1 day ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Clinical Medical Review Nurse. Be the first to apply!