Remote Nurse — Clinical Quality Review Specialist
SPECTRAFORCE
- Remote job
SPECTRAFORCE is seeking a Clinical Quality Reviewer to support PQI investigations with remote health plan/IPA experience. The role requires extensive clinical knowledge across hospital and behavioral health settings and reports to the Manager, Clinical Quality Review. Responsibilities include analyzing quality issues, determining review levels, presenting cases to physician committees, and developing corrective action plans. #J-18808-Ljbffr SPECTRAFORCE
- ...operations and supporting production teams, the full-time Quality Review Specialist will ensure the accuracy of data in client files and company... ...participating in the implementation of quality processes, all in a remote work environment. Key responsibilities Responsible for the...Remote workFull timeWork experience placement
- Cooperidge Consulting Firm is seeking a Coding Quality Review Specialist for a top healthcare client based in Nashville, TN (remote position). The CQR Specialist performs internal quality assessments of coding accuracy and compliance across inpatient and outpatient records...Remote workShift workWeekend work
- Obsidian is seeking experienced visual quality reviewers to join a leading AI lab's cutting-edge GenAI team in San Francisco. The role involves... ...tools for effective evaluation. Opportunities for part-time, remote work with flexibility are also available. #J-18808-Ljbffr...Remote workPart time
$64.5k - $92.2k
Gainwell Technologies LLC is seeking a Clinical Quality Nurse Reviewer, Sr. Specialist to perform ongoing quality assurance audits on clinical staff. This full-time remote position requires an active RN license and clinical experience in healthcare. Responsibilities include...Remote jobFull time$27.07 - $53.08 per hour
...Optum Insight Quality Review Operations Specialist Optum is a global organization that delivers care, aided... ...'ll enjoy the flexibility to work remotely * from anywhere within the U.S. as... ...Hybrid datamining experience ~ Clinical and/or Health Education experience...Remote jobHourly payFor contractorsWork experience placementShift workNight shiftWeekend work$65k - $75k
...Nurse - Clinical Review Performs utilization review of cases to determine if the request meets medical... .... Appropriately identifies and refers quality issues to UM Leadership. Assists... ...10:30amCST - 7:00pm CST Location: Remote Benefits - Medical, Dental, & Vision...Remote workWork at officeLocal areaMonday to Friday- Machinify is seeking a Medical Review Nurse II to perform medical claims audit reviews for Government... ...of relevant experience. The position is remote, and you will be part of a dynamic,... ...with teams to ensure compliance and quality. Preferred qualifications include expertise...Remote job
$85k - $105k
## Quality Associate, Batch Record Review and Product DispositionApplylocations: San Diegotime type: Full timeposted... ...Review, Product Disposition, Clinical and Commercial Supplier Management... ...Diego. No role is expected to be 100% remote* Ability to travel 10-20%...Remote workContract workTemporary workShift work$69.3k - $78k
Overview Medical Review Nurse II - Clinical Validation At Performant, we’re focused on helping our clients... ...to focus on what matter most - quality of care and healthier lives for all.... ...and Commercial Payers. You will work remotely in a fast paced and dynamic environment...Remote workFor contractorsWork at officeWork from homeHome officeShift work$65 - $95 per hour
...About the job Remote | Nursing Clinical Review Expert - $65-$95/hour We are sharing a specialised part-time consulting opportunity for nursing... ...administration scenarios, clinical data review, and high-quality project execution. Selected professionals will apply...Remote workHourly payWeekly payContract workPart timeFor contractorsFlexible hours- ...contractor position. We need a Nurse Practitioner who can... ...and completely remote. We require at least 5... ...will be responsible for reviewing pertinent patient data,... ...received for accuracy of clinical and demographic information... ...plans Support Data Quality Reviewers, LPN Reviewers...Remote workFor contractors
$50 per hour
...About the Job Registered Nurse Clinical Reviewer - Remote (New York) Location: Remote (New York-based) Employment Type: Full-time Pay... ...remote role, you'll conduct utilization reviews and quality study data collection, ensuring compliance and accuracy across...Remote workFull time- ...services organization is seeking a Respiratory Therapist to conduct expert clinical reviews for the U.S. Department of Veterans Affairs. This remote role involves evaluating charts, completing quality reviews, and maintaining strict confidentiality of records. Candidates...Remote work
$36.91 - $50.62 per hour
...your best work. Job Summary Performs quality reviews and audits to ensure compliance with DRG... ...Licenses/Certifications Certified Coding Specialist credential through AHIMA: Required... ..., company policies and procedures, and clinical/medical resources to assure coding knowledge...Remote jobHourly payFull timeShift work$35 per hour
...games, uncovering hidden gems of user experiences? As a Remote Application QA Specialist, you'll embark on an exciting adventure where creativity... ...impactful contributions! Roles: In this role, you’ll help review mobile apps by installing them on your device and testing...Remote jobHourly payContract workFixed term contractStart working todayWork from home- Cloverhealth is seeking a Registered Nurse (RN) Medicare Quality Assurance Reviewer to support their Utilization... ...team. The role involves providing clinical expertise, conducting quality assurance... ...offers a competitive salary with remote work flexibility and numerous...Remote job
$50 per hour
Overview Registered Nurse Clinical Reviewer / IDR - Remote to Office-Based, Jericho, NY (ID #25302) Location: Remote to Office-Based, Jericho, NY Employment Type: Full-time Hourly Rate: $50/hr About Greenlife Healthcare Staffing: Greenlife Healthcare Staffing is a...Remote workHourly payFull timePrivate practiceWork at officeFlexible hours- ...A healthcare organization is seeking a Clinical Review Nurse – Concurrent Review to perform utilization management functions remotely. The role requires conducting concurrent reviews... ...with medical teams, and ensuring quality healthcare outcomes. Candidates should have...Remote workWork at office
- ...motivated candidate to join our talented Team. Job Title: Clinical Medical Review Nurse. Location: Owings Mills, MD. Summary: The Contingent RN... ...with professionalism and a collaborative mindset. Remote work environment with minimal physical demands. Ampcus...Remote work
- ...Comagine Health is seeking a Clinical Utilization Review Nurse (RN) to work remotely. This role involves assessing the necessity and quality of healthcare services through various review methods, ensuring compliance with clinical criteria. The ideal candidate must hold...Remote work
- ...COMAGINE HEALTH is seeking a Clinical Utilization Review Nurse (RN) to conduct utilization management reviews... .... This full-time role supports high-quality care delivery while ensuring... ...relevant experience. The position is remote, allowing work from any location in...Remote workFull time
- ...Summary: Work Mode: Remote Duration: 3 months,... ...Perform medical necessity and clinical reviews of authorization requests to... ...utilization processes to promote high quality and cost-effective medical... ...an Accredited School of Nursing OR Bachelor's degree in...Remote workFull timeWork at officeMonday to Friday
- ...Role : Clinical Medical Review Nurse Location : Canton, MD (Hybrid - 2-3 days onsite per week)... ...Registered Nurses (RN) to join the Quality team as Clinical Medical Review Nurses... ...hybrid contract position requiring both remote work and regular onsite presence at...Remote workContract workWork at office2 days per week3 days per week
- Network Medical Review is seeking a Clinical Quality Assurance Coordinator. This role, designed for licensed nursing professionals, allows you to work 100% remote while ensuring the quality of peer review case reports. Responsibilities include reviewing reports for compliance...Remote job
- Myaegis is hiring an Oasis / Coding Review Specialist in Mesa, AZ. This full-time role involves reviewing clinical charts, supporting quality improvement initiatives, and coaching clinicians. The ideal candidate has a healthcare background (LPN, RN, PT, or PTA) and must...Remote jobFull time
- ...Comagine Health is looking for a Clinical Utilization Review Nurse (RN) to perform remote assessments on the medical necessity of healthcare services. This full... ...and ensuring compliance with clinical policies for quality care. Candidates should possess a BA/BS in...Remote workFull time
- ...CLINICAL REVIEW NURSE - REMOTE ARC Group has multiple positions open for Clinical Review Nurses! These positions are 100% remote. These are... ...firm working with clients nationwide to recruit the highest quality technical resources. We have achieved this by...Remote workPermanent employmentWork at officeLocal area
- ...Overview Clinical Review Nurse - Concurrent Review TX Location: 100% Remote - TX: RN only with TX license SHIFT: Tuesday – Saturday 8am-5pm CST- schedule is... ...setting of care, and assess overall health. Review quality and continuity of care by evaluating acuity...Remote workContract workShift work
$38.67 - $59.94 per hour
...Position Highlights: Position: Quality Review Specialist Location: Glenview, IL Full... ...~ Collect, review, and analyze clinical data and documentation related to potential... ...peer review outcomes. ~ Support nursing peer review practice, indicator...Hourly payFull timePart timeFor contractorsWork experience placementWork at officeMonday to Friday$27.02 - $48.55 per hour
...considered. The standard fully remote work schedule is Monday... ...Perform concurrent reviews, including determining... ...level of care. Review quality and continuity of care... ...necessity based on clinical policies and guidelines... ...an accredited school of nursing or a Bachelor’s degree...Remote workHourly payWork at officeMonday to FridayFlexible hours
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