Remote Clinical QA Coordinator (RN) - Utilization Review
AllMed Medical Management
Portland, OR
- Remote job
AllMed Medical Management is seeking a Clinical Quality Assurance Coordinator, an RN who is detail-driven and passionate about quality. This 100% remote role supports Pacific Time Zone operations, with a Sunday-Thursday 8:00am-4:30pm PST schedule. You will review care against evidence-based guidelines to ensure medical necessity and adherence to client agreements and federal/state mandates. You will collaborate with providers, document findings, and help maintain URAC and HIPAA compliance while #J-18808-Ljbffr AllMed Medical Management
Vacancy posted 3 days ago
Similar jobs that could be interesting for youBased on the Remote Clinical QA Coordinator (RN) - Utilization Review in Portland, OR vacancy
- AllMed is seeking a Clinical Quality Assurance Coordinator to perform quality utilization reviews and ensure medical necessity aligns with evidence-based guidelines. This 100% remote role supports Pacific Time Zone operations and may require occasional weekend coverage...Remote job
- AllMed is seeking a Clinical Quality Assurance Coordinator (RN) to lead quality utilization reviews and ensure medical necessity in accordance with evidence-based guidelines. The role is 100% remote, requiring a strong knowledge of HIPAA, URAC standards, and regulatory...Remote job
- ...Medical Management is seeking a Clinical Quality Assurance Coordinator. This 100% remote role supports Pacific Time Zone... ...focuses on high-quality utilization reviews and adherence to evidence-based... ...requirements. The ideal candidate is an RN with UMR/IRO experience, strong...Remote job
- ...CVS Health Corporation is seeking an RN Concurrent Review Nurse to join a remote team delivering inpatient clinical expertise to ensure medically necessary care across... ...5+ years inpatient nursing, and 2+ years in utilization management or discharge planning, with an Associate...Remote workWork from homeMonday to FridayWeekend work
CVS Health
Jackson, MS4 days ago - ...A healthcare staffing firm is seeking a skilled Utilization Review RN to join their team. This fully remote position requires a valid PA RN license and prior experience... ...review. Responsibilities include conducting clinical reviews, applying evidence-based criteria for...Remote work
IntePros
United States4 days ago - Clinical Review Lead Coordinator, LPN/RN General information Date Monday, October 26, 2026 City Remote Country United States Working time Full-time Description & Requirements Join... ...Experience with clinical review, utilization management, or appeals. Knowledge of...Remote workMinimum wageFull timeContract workTemporary workWork experience placement
- ...MCMC seeks a Clinical Quality Assurance Coordinator to review peer review reports from home, ensuring... ...and regulatory alignment. RN/LPN/LVN license required,... ...presentation, while supporting QA improvements and client satisfaction in a 100% remote setting. #J-18808-LjbffrRemote work
MCMC
Atlanta, GA4 days ago - ...MES Solutions is seeking a self-driven RN or LPN to join our remote Clinical Quality Assurance team. You will oversee peer review reports, ensure alignment with client agreements and regulatory standards, and maintain high-quality documentation while protecting confidentiality...Remote workMonday to Friday
MES Solutions
New York, NY1 day ago - ...Sedgwick is seeking a Telecommuter RN for Utilization Review in the United States. The role requires an active RN license, an associate degree... ...utilization review. Certification is a plus. The position offers remote work with a comprehensive benefits package and competitive...Remote work
Sedgwick Claims Management Services
United States2 days ago - Leave Your Mark is seeking a Registered Nurse for Utilization Review to support a Michigan health plan client from a home-based setting. The... ..., and length of stay for various services. You will apply clinical judgment and evidence-based criteria, work with the medical...Remote jobWork from home
$30 - $38 per hour
...A healthcare organization is seeking a part-time Utilization Review Nurse RN to conduct assessments and reviews for medical necessity of treatment... ...must have a current RN license and at least 1 year of clinical experience. Competitive hourly compensation worth $30-$38...Remote workHourly payPart timePersonify Health, Inc.
New York, NY1 day ago- ...seeking a Registered Nurse for Utilization Management in a remote-capable role. This position focuses on reviewing admissions and service requests for medical necessity, coordinating care, and ensuring... ...organization. The role requires Texas RN licensure and a nursing...Remote work
Ascension
United States4 days ago $69.39k - $88.61k
...Cincinnati Children’s is seeking an experienced Utilization Review professional for a remote role in the United States. The position supports case... ...a Bachelor’s degree in a related field, an active RN/Social Work/Clinical Counselor license, and 2+ years of related...Remote workFull timeCincinnati Children's
New York, NY2 days ago- ...Network has been asked to assist a top health plan partner of ours with a need for an experienced RN Case Manager with Utilization Review/UM experience. This position is remote based and requires an activeMA RN license. (Compact RN license may be possible for other plans)...Remote workContract workMonday to FridayFlexible hours
Community Health Network
Boston, MA3 days ago - ...Intermountain Health is seeking an RN Utilization Review Care Management I for a fully remote, part-time role. The position covers enterprise-wide shifts with on-call and weekend rotations, requiring RN licensure with a compact license within the service area. Responsibilities...Remote workPart timeShift workWeekend work
Intermountain Healthcare
Madison, WI1 day ago - ...Cincinnati Children e s Hospital Medical Center is seeking a Remote Utilization Review professional to perform admission and continued stay reviews using InterQual, ensuring medical necessity and appropriate level of care.The role collaborates with Admitting, Financial...Remote work
Cincinnati Children's Hospital
United States2 days ago $1,949.74 per month
...Registered Nurse Specialty Utilization Review Job ID 17979666 Job Title Utilization Review RN Weekly Pay $1949.74 Shift... ...13 Week(s) Job Description Remote Utilization Review RN responsible for concurrent...Remote workWeekly payShift workProvidence Health and Services
Eureka, CA4 days ago- ...LLC team is seeking a skilled Medical Reviewer to evaluate a variety of medical claims... .... Candidates must hold an active RN license in the United States and an associate... ...candidates have BSN and additional clinical and utilization review experience, plus proficiency in...Remote jobWork from home
- MES Solutions is seeking a Clinical Quality Assurance Coordinator to review peer reports remotely and ensure accuracy, citations, and regulatory compliance. The role requires an active RN or LPN license and at least two years of clinical experience. You will verify client...Remote jobMonday to Friday
$65 per hour
...Fully Remote Position Job Title : RN - UTILIZATION REVIEW Location: Everett, WA 98201 Start Date: 05/04/2026 Duration: 13 weeks Schedule Shift: Day 5x8-Hour (08:00 - 16:30) Shift Notes: Days (5×8) | 08:00 - 16:30PAY DETAILS (72 HOURS / 2 WEEKS)...Remote workLocal areaImmediate startMonday to FridayShift workWeekend workPacer Group
Everett, WA2 days ago- ...LTSS department. RN will be responsible... ...authorization and concurrent review. Provides monthly... ...setting by utilizing the applicable... ...resources. Applies clinical knowledge to work... ...for care coordination. Works with medical... ...Info: *possible remote opportunity after...Remote workContract workMonday to FridayFlexible hours
HealthCare Support
New York, NY2 days ago - Concierge Home Care is seeking an experienced Utilization Review Specialist (RN) to join our remote home health team. The role emphasizes OASIS review, coding, QA, and documentation oversight while maintaining compliance with Medicare guidelines. This remote position is...Remote job
$63k - $94k
...Remote Utilization Review Registered Nurse (UR RN) Are you an experienced RN looking to transition away from the bedside... ...act as a vital bridge between clinical care and hospital operations,... ...referrals. Denial Management & Appeals: Coordinate the Peer-to-Peer (P2P) process...Remote workWork at office10 hours per weekFlexible hoursShift workWeekend workAfternoon shift3 days per weekMedix
New York, NY1 day ago- Intermountain Health is seeking an RN Utilization Review Care Management I for fully remote work. This role focuses on utilization review screenings, assessments, and evaluations to promote cost-effective, high-quality care, collaborating with patients, families, providers...Remote job
- HealthEdge is seeking a highly motivated Utilization Review RN to join our team. The role involves... ...outpatient settings. The position supports remote work in the US, requires an... ...discharge planning, documentation, and coordination with providers and plans. #J-18808-Ljbffr...Remote jobContract work
- HonorHealth is seeking an experienced Utilization Review RN Specialist for a remote-capable role serving the greater Phoenix area. The position focuses on reviewing medical necessity and coordinating reviews for diverse payers, ensuring appropriate level of care and data...Remote job
- Intermountain Health is seeking an RN Utilization Review Care Management I for remote, part-time coverage across enterprise regions. The role focuses on utilization... ..., and insurers. The position emphasizes strong clinical judgment, knowledge of guidelines (InterQual/MCG),...Remote jobPart time
- TriWest Healthcare Alliance is seeking a Utilization Management Clinical Review nurse to assess medical necessity and manage prior authorizations for Behavioral... ...for Medical Director review. The role requires an active RN license, US citizenship, and the ability to obtain DoD...Remote job
$65k - $85k
...Concierge Home Care | Remote Opportunity | Growth Opportunities... ...looking for an experienced Utilization Review Specialist (RN) to join our remote home... ...experience in OASIS, coding, QA, and home health... ...You’ll Do Review home health clinical documentation for accuracy...Remote workMonday to FridayWeekend workWeekday workConcierge Home Care
United States14 hours ago- Optum is seeking a Per Diem Utilization Management Nurse to review medical records and craft defensible appeal letters. You will extract pertinent case details, adhere to HIPAA, and follow OPAS/Optum guidelines while meeting time expectations. The role offers telecommuting...Remote jobDaily paidLocal area
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Clinical QA Coordinator (RN) - Utilization Review. Be the first to apply!
Related searches
- clinical data coordinator remote Portland, OR
- clinical trial coordinator Portland, OR
- medical coordinator Portland, OR
- clinical pharmacy coordinator Portland, OR
- kaiser rn Portland, OR
- outpatient rn Portland, OR
- sedation rn Portland, OR
- 1099 rn Portland, OR
- ed rn Portland, OR
- registered nurse office Portland, OR