Remote RN: Clinical Reviewer & QIDP (Alabama)
Anacalifornia
- Remote job
Comagine Health is seeking an RN to perform Clinical Review work and QIDP reviews. The role is remote, with half-time focus on QIDP reviews and half-time on nurse clinical review. The position requires licensure in Alabama, a BA/BS in Nursing, and at least 3 years of direct patient care experience. Responsibilities include applying Medicaid criteria, coordinating with physicians, and ensuring timely reviews while maintaining compliance with state and federal requirements. #J-18808-Ljbffr Anacalifornia
- Comagine Health is seeking an RN to perform Clinical Review work and QIDP reviews. The role will split time as a QIDP (.5 FTE) and a nurse clinical reviewer (.5 FTE); you will operate remotely from Alabama and hold an active RN license in the state with a minimum of 3 years...Remote job
- Comagine Health seeks Clinical Utilization Review Nurses (RN) to assess medical necessity and quality of care through prospective, concurrent, and retrospective reviews. This full-time, remote position requires Alabama licensure and focuses on compliant, cost-effective...Remote jobFull timeContract work
- ...care delivery and patient outcomes. Our talented remote workforce spans the country and plays a vital role... ...professionally. Position Overview We are seeking Clinical Utilization Review Nurses (RN) based in Alabama to assess the medical necessity and quality of healthcare...Remote workFull timeContract work
$62.7k - $100.4k
...Job Summary: Clinical Care Reviewer II is responsible for processing medical necessity reviews for appropriateness of authorization for health... ...(A.S) Completion of an accredited registered nursing (RN) degree program required Three (3) years clinical experience...Remote workHourly payWork at office- ...seeking a Registered Nurse to perform medical reviews using clinical information and established guidelines. The... ...claims and utilization practices from a remote location in South Carolina, Georgia, North Carolina or Alabama. Responsibilities include educating staff on...Remote job
- UnitedHealth Group seeks an experienced SSBV Clinical Claims Review RN to perform administrative reviews of short stay inpatient hospital claims. The role requires documenting determinations and maintaining screening criteria, contributing to efficient, compliant health...Remote job
$45 - $50 per hour
...Healthcare Staffing is looking for a dedicated Registered Nurse Clinical Reviewer for a fully remote position in New York. This role involves conducting... ...of accredited nursing programs with an active New York RN license. #J-18808-Ljbffr kozmetickesluzby.vecnakraska.sk...Remote jobHourly pay- NTT DATA, Inc. in Tampa, Florida seeks a BPO Clinical Review Specialist to perform clinical and medical necessity reviews supporting member... ...compliance with NCQA standards and Medicaid guidance. This remote Florida role offers benefits including medical, dental and vision...Remote job
- 1 week ago Be among the first 25 applicants Job Title:Clinical Review Nurse (RN) - Utilization Management Location:Oregon or bordering states Duration... ...(Future Opportunities) Clinical Program Coordinator RN *Remote* Clinical Program Coordinator RN *Remote* Medford, OR $2,26...Remote workContract work
- ...guidelines, and following internal procedure to determine the viability of the claim for further review in a production environment. Primary Responsibilities: Clinical Case Reviews - 75% Perform clinical review of professional (or facility) claims vs. medical...Remote jobContract workWork at officeLocal areaMonday to Friday
$32 - $33 per hour
...experience to contribute, we are committed to making your unique situation fit into our culture. We have an opening for a: RN - Clinical Field Reviewer (Remote in Montana) The RN Clinical Field Reviewer is a remote position that requires in-home nursing assessments which...Remote workFull timeTemporary workLocal area- A leading organization in healthcare quality is seeking a Clinical Quality Reviewer to review clinical cases and identify potential quality or safety concerns. This remote position is ideal for licensed clinical professionals with a strong analytical mindset and a minimum...Remote job
- Comagine Health in Alabama is seeking Clinical Utilization Review Nurses (RN) to assess medical necessity and quality of care through prospective, concurrent, and... ...utilization reviews. This is a full-time remote role supporting Alabama contracts. You will apply Alabama...Remote jobFull time
- ...Unknown CDI team is seeking a Clinical Documentation Integrity (CDI) Specialist – RN for a 100% remote position based in the United States. You will drive accurate inpatient documentation, engage physicians, and ensure alignment with quality and reimbursement goals....Remote work
- ...Stryker Corporation in the United States is seeking a Clinical Documentation Integrity (CDI) Specialist – RN for a fully remote role. You will review inpatient records, issue physician queries, and collaborate with care teams to ensure accurate reflection of severity of...Remote work
- ...UVA Health seeks a Clinical Documentation Specialist with nursing experience to ensure the clinical story is accurate and complete across the health system. This fully remote opportunity requires at least three years in CDI or a similar role and a strong acute care...Remote work
- ...Washington, DC is seeking a DME Medical Reviewer to ensure compliance with nursing... ...candidate must hold an active RN license and have at least two years of clinical experience. Responsibilities... ...quality audits. The role emphasizes remote work capabilities and adherence...Remote work
$70k - $120k
...Fully Remote : Clinical Documentation Specialist Job Description Facilitate the improvement... .... Perform concurrent and retrospective reviews of medical records to ensure accurate... ...Qualifications Registered Nurse (RN) with a current license from any state....Remote workLocal areaMonday to Friday$50k
...Department Overview The Clinical Documentation Specialist will provide active, concurrent and retrospective review of provider documentation, query for clarification, provide... ...comprehensive review of patient records in a remote setting. The Registered Nurse provides...Remote workFull timePart time$125k - $160k
...'s lives. This position is remote. Candidates must be local to New... ...for consideration The Clinical Documentation Improvement (CDI... ...Description: Concurrently reviews inpatient records to ensure completeness... ...& Registration: RN License Clinical Documentation...Remote workWork at officeLocal area- ...Clinical Documentation Improvement (CDI) Specialist Registered Nurse (RN)When you join the growing BILH team, you're not just taking... ...people's lives.This position is remote. Candidates must be local to... ...limited to:Completes initial reviews of patient records within 24-4...Remote workWork experience placementWork at officeLocal area
$50.14 - $77.83 per hour
...Description CLINICAL DOCUMENTATION SPECIALIST RN - Providence Home Services Oregon Schedule: Full time, Day shift / This is a remote position working on day shift. Note: Candidate... ...Nurse (RN) is responsible for quality review of all OASIS admission documents...Remote workMinimum wageFull timeShift workDay shift$80k
...documentation for any patient clinical condition or procedure to support... .... Extensive medical record review and interaction with physicians... ...Education ~ Current RN Licensure Certifications... ...Monster Top Workplace for Remote Work 2024 Great Place to Work...Remote workLocal area$38.67 - $59.94 per hour
...experience, among other factors. Clinical Documentation Specialist... ...Location: Hybrid - Skokie, IL and remote Full Time/Part Time: Full... ...What you will do: Review medical records concurrently to... ...Certification: ADN or RHIT; IL Licensed RN Preferred Experience: 3-5...Remote workHourly payFull timePart timeFor contractorsWork at officeMonday to Friday- Palmetto GBA is seeking an experienced RN for remote utilization review to evaluate medical claims using established criteria and guidelines. The role... ...position requires active RN licensure and 2+ years of clinical experience, with strong communication and analytical skills...Remote jobWork from homeHome office
$45 per hour
SPECTRAFORCE is seeking a Clinical Appeals Specialist to handle member-generated appeal processes remotely from California. The role involves reviewing medical records and ensuring compliance with... ...communication skills. A California RN license and ADN are required. The position...Remote jobHourly pay- Gainwell Technologies is seeking a Medical Reviewer (Registered Nurse) to support California healthcare programs. You will use clinical judgment to review medical records,... ...and authorization requests. You will work remotely within California with flexible hours, contributing...Remote jobFlexible hours
- Montefiore St. Luke's Cornwall is seeking a Clinical Documentation Integrity Specialist (CDIS)... ...: Bachelor’s Degree in Nursing, valid RN license, 3+ years acute care nursing and... ...Office/MS Teams; ability to troubleshoot remote #J-18808-Ljbffr Montefiore St. Luke's CornwallRemote job
- Providence Home Services Oregon is seeking a Clinical Documentation Specialist RN to perform quality reviews of OASIS admission documents and Plan of Care to ensure CMS compliance. The role partners with Home Health leadership to promote regulatory compliance and best patient...Remote job
- Providence Home Services Oregon is seeking a Clinical Documentation Specialist, Registered Nurse (RN) for a full-time, day-shift remote role open to multiple states. You will review OASIS admission documents and Plans of Care to ensure CMS compliance and optimal reimbursement...Remote jobFull timeDay shift
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