Remote Medical Management Nurse Clinical Case Review
$75.77k - $113.66kElevance Health
A healthcare company is seeking a Medical Management Nurse to handle complex cases that require clinical judgment and critical thinking. This role allows for virtual work but requires in-person training sessions. Responsibilities include reviewing cases for medical necessity and consulting with healthcare providers. Candidates must possess an associate's degree in nursing, an RN license, and extensive experience in care management. The salary ranges from $75,772 to $113,658 depending on qualifications and location. #J-18808-Ljbffr
$75.77k - $113.66k
A healthcare company is looking for a Medical Management Nurse to review complex cases and utilize nursing judgment to determine medical necessity. This role offers maximum flexibility with virtual work options and involves collaborating with healthcare providers to ensure...Remote work- ...Institute is seeking a Concurrent Review Case Manager responsible for telephonic... ...and documentation of medical treatments, ensuring guidelines... ...hold an Associate Degree in Nursing or higher and have an active... ...review. The role allows for remote work flexibility across the...Remote work
- ...Accountable for daily management of assigned cases, adhering to client turnaround... ...Complete preliminary review of medical cases ensuring all tasks... ...accuracy. Support non-clinical staff with clinically related... ...A Bachelor's degree in Nursing; Preferably PHRN and holds...Remote workWork from homeFlexible hours
- Working as a Nurse Case Manager at Cunningham Childrens Home means youll be... ...programs through: Medical case management Screening... ...schedule, primarily providing remote phone consultations, ensuring... ...organizational, communication, and clinical skills Employees have...Remote workTemporary workRelocationRelocation packageFlexible hours
- ...A healthcare company is seeking a Remote Medical Case Reviewer to evaluate vaccine and countermeasure-related injury claims. Responsibilities include reviewing medical case files, preparing reports, and consulting with medical experts. Candidates must hold an MD/DO or...Remote workContract work
- ...A medical review company is seeking experienced Physical Therapists to join their team as independent contractors. This telework role... ...while offering the chance to conduct comprehensive reviews of clinical cases. Candidates will be expected to prepare clinical summaries and...Remote workFor contractors
$65 - $95 per hour
...About the job Remote | Nursing Clinical Review Expert - $65-$95/hour We are sharing a specialised... ...patient care, clinical monitoring, medication administration, clinical... ...clinic, long-term care, home health, case management, telehealth, or healthcare quality...Remote workHourly payWeekly payContract workPart timeFor contractorsFlexible hours$34 - $40 per hour
...Clinical Review Nurse: Description Duals Program Details-... ...in 2027. They are managing both Medicare and Medicaid... ...and average 1.85 cases per hour. Skills... ...interqual, managed care, medical management, acute... ...Type This is a fully remote position....Remote workHourly payContract workTemporary work- ...advanced technical and clinical solutions that... ...orientated Nurse Supervisor to join... ...responsible for Utilization Management (UM) activities,... ...of clinical staff Reviewing pre-authorization... ...pain management, case management, or health... ...not limited to: medical, dental, vision,...Remote workFull time
- ...Job Summary The Clinical Reviewer, Precertification... ...licensed Registered Nurse that is expected... ...is responsible for managing a clinically... ...responsible for determining medical necessity and... ...and disposition of cases. Orients new... ...Candidates can be remote but must have an active...Remote workContract workWork at officeWork from home
$50 per hour
...About the Job Registered Nurse Clinical Reviewer / AIMS - Remote (#25299A) Location: Remote. Employment Type: Full-time. Hourly Rate: $50/hr. Position Overview: We are seeking an experienced Registered Nurse Clinical Reviewer to join a Non-profit...Remote workHourly payFull time$125k - $201k
...Job Summary: Clinical Care Reviewer II is responsible for processing medical necessity reviews for appropriateness of authorization... ...appropriate members for Care Management Provide guidance to non-... ...of an accredited registered nursing (RN) degree program required...Remote jobHourly payWork at office- ...position. We need a Nurse Practitioner who... ...discretion and completely remote. We require at... ...responsible for reviewing pertinent patient... ...and Chronic Care Management (CCM) services. PRIMARY... ...for accuracy of clinical and demographic... ...of each patients’ medical history, care plan...Remote workFor contractors
- CLINICAL REVIEW NURSE - REMOTE ARC Group has multiple positions open for Clinical Review Nurses! These... ...responsible for reviewing and making medical determinations as to the validity of... ...appropriateness of care which may include cases requiring prior authorization,...Remote workPermanent employmentWork at officeLocal area
$130k - $135k
...for patients in skilled nursing facilities. We deliver... ...Lead in the Chronic Care Management (CCM) department, you... ...provide assistance to a Clinical Manager. You will be responsible for chart reviews, onboarding process,... ...chronic care management. Remote work experience beneficial...Remote workWork experience placementWork at officeWeekend work$75k - $88k
...Cottage Hospital is seeking a Telephonic Nurse Case Manager to assess and coordinate care for... ...Responsibilities include planning and implementing medical case management, ensuring timely communication with all stakeholders, and reviewing medical records for compliance. The...Remote work$80k
Registered Nurses are encouraged to consider a full-time Clinical Reviewer position with Liberty Healthcare. As a Clinical Reviewer... .... Responsibilities Reviewing medical records and personal health... ...with stakeholders This is a remote‑first position that primarily allows...Remote workFull timeWork from home- ...Physician, Medical Case Reviewer (Remote, Part-Time, Flexible Hours) At Broadway Ventures, we transform... ...opportunities with expert program management, cutting-edge technology, and... ...flexible, remote opportunity to apply your clinical expertise? We are seeking...Remote workPart timeFor contractorsCurrently hiringFlexible hours
- Harris Health System, Inc. is seeking a Utilization Management Review Nurse (UMRN) in Bellaire, TX. This position involves evaluating medical service necessity and efficiency, ensuring quality care based on clinical guidelines. The UMRN will work closely with various departments...Remote jobFlexible hours
$21 per hour
...to loading, unloading, sorting, or scanning roles depending on operational needs. Employees may be eligible for benefits including medical, dental, and vision insurance, tuition assistance programs, 401(k), pension benefits (in union locations), paid time off, and...Hourly payFull timeShift workNight shiftDay shiftEarly shift- A leading medical review firm is looking for expert reviewers in Washington, DC. This telework... ...include evaluating medical records, providing clinical summaries, and answering client... ...initial training while contributing to a streamlined case flow. #J-18808-Ljbffr Dane StreetRemote jobFor contractors
- ...Remote Medical Case Reviewer (Contract) Location: Remote About the Opportunity PsyPhyCare... .... Ensure compliance with records management, HIPAA, and confidentiality standards... ...At least 5 years of experience in clinical practice or case review. Strong writing...Remote workHourly payContract work
- ...Title: Non-Clinical Nurse Case Manager Location: Colchester, VT (Hybrid/Telework Eligible) Job... ...personnel readiness. Coordinate care, track medical cases, and ensure compliance with... ...(MEB/PEB) Conduct monthly case reviews and reporting Support readiness events...Remote work
- ...Registered Nurse III - Non-Clinical Case Manager Colchester, VT ( Description KSA Integrationis a Service... ...Service Members. Benefits: • Medical, Dental, Vision (82% of employee’s... ...records for and attend MEB/PEB boards; review and reconcile hardcopy and...Remote workFull timeContract workFor contractorsWork at officeFlexible hours
- ...love your Mondays as the Nurse Director Utilization Review and Case Management at an award winning... ...quality results; strong clinical excellence and safety standards... ..., virtual nursing, and remote monitoring; clear... ...tomorrow—pairing comprehensive medical, dental, and vision...Remote workWeekend work
- ...you're a registered nurse looking for a new... ..., responsible for medically managing assigned caseload and by applying clinical expertise ensure... ...medical/disability cases, lost time, and/or... ...partners. This is a remote position however,... ...i.e., Utilization Review, Peer Review,...Remote workWork at officeLocal area
- ...Guidehealth leverages remotely-embedded... ...and a centralized Managed Service Organization... ...DoingUtilization Review & Clinical DeterminationsComplete... ...appropriate medical criteria to support... ...Reviewers for cases requiring medical... ...aligned with Illinois nursing regulations and...Remote workBi-weekly payFull timeTemporary workFor contractorsLocal area
- ...Remote Telecommute Work From Home Job Description: We are looking for remote, telecommuting... ...part-time or full-time You get to review and use new products or services... ...warehouse or factory worker, driver, medical assistant, nurse or health care worker, call center or...Remote workFull timeTemporary workPart timeWork from homeFlexible hours
$40 - $45 per hour
...Registered Nurse (RN) | Case Manager Location: Jacksonville, NC Agency:... ...Title : Case Manager/ Case reviewer Day to Day Responsibilities... ...will include 80% travel. Remote role. Will require a driver... ...and appeals. Licensed Clinical Social Worker/Registered...Remote workHourly payFull timeImmediate startShift work3 days per week$670 per week
...A remote work organization is seeking a part-time Administrative Assistant to manage clerical responsibilities from home. The role offers a flexible schedule averaging 3-6 hours weekly, and tasks include handling appointments, managing communications, and assisting with...Remote workPart timeWork from homeFlexible hours
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