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

Remote RN: Prior Authorization Clinical Reviewer

Centene Corporation

Centene Corp. is looking for a Clinical Review Nurse - Prior Authorization to work remotely. This position entails analyzing prior authorization requests to determine medical necessity, working with healthcare providers for timely reviews, and maintaining compliance with regulatory guidelines. Applicants must have an active New York State RN licensure and a degree from an Accredited School of Nursing, with 2-4 years of related experience preferred. The role follows a Monday–Friday schedule from 8:30 AM to 5:00 PM ET. #J-18808-Ljbffr

Vacancy posted 12 hours ago
Similar jobs that could be interesting for youBased on the Remote RN: Prior Authorization Clinical Reviewer in New York, NY vacancy
  •  ...Acentra Health, LLC is seeking a Clinical Reviewer of Behavioral Health to...  ...contract requirements. This remote position requires work aligned...  ...have an active Virginia RN or LMHP license and at least 1 year of experience in Prior Authorization or Utilization Review. Acentra... 
    Remote work
    Contract work

    Acentra Health, LLC

    New York, NY
    2 days ago
  • $28.37 - $36 per hour

     ...through technology, services, and clinical expertise. Our mission is to innovate...  ...Health is looking for a Clinical Reviewer - RN - PRN (Remote U.S.) to join our growing team....  ...Utilization Management (UM), OR Prior Authorization. ~1+ years of knowledge of InterQual... 
    Remote work
    Contract work
    Work experience placement
    Relief
    Work at office
    Local area
    Monday to Friday
    Flexible hours

    Acentra Health

    McLean, VA
    11 days ago
  •  ...this position is to utilize clinical expertise to review medical records against...  ...requirements. Location: Remote (U.S.-based) Licensure Requirement...  ...unrestricted  LPN/LVN or RN license in Indiana or...  ...Management (UR/UM) and/or Prior Authorization experience ~2+ years of... 
    Remote work
    Contract work
    Work at office
    Monday to Friday
    Weekend work
    Weekday work

    Astyra Corporation

    Indianapolis, IN
    16 days ago
  • $80k

     ...Liberty Healthcare Corporation Career Center is looking for a full-time Clinical Reviewer to join their team. This remote-first role involves reviewing medical records, conducting analyses, and writing objective reports. In addition to a competitive annual salary of $8... 
    Remote work
    Full time

    Liberty Healthcare Corporation Career Center

    Omaha, NE
    3 days ago
  •  ...Q-Centrix is seeking a Senior Clinical Data Specialist to join our team in Chicago, focusing on delivering quality solutions to healthcare...  ...in MS Office, and hold active SCR certification along with RN credentials. We value critical thinkers who can thrive independently... 
    Remote work

    Q-Centrix

    Chicago, IL
    3 days ago
  •  ...A national nonprofit organization is seeking a Registered Nurse (RN) to perform Clinical Review work and QIDP reviews. This remote position requires an active RN license in Alabama and at least three years of direct patient care experience. Key responsibilities include... 
    Remote work

    Comagine Health

    Las Vegas, NV
    11 hours ago
  •  ...Position Overview We are seeking an RN to perform Clinical Review work and QIDP reviews work. Team member will serve as the QIDP (.5 FTE) and as...  ...Requirements & Work Environment This position is primarily remote and performed in a home-based setting, requiring reliable... 
    Remote work
    Contract work

    Comagine Health

    Sacramento, CA
    4 days ago
  • $50 per hour

     ...Overview RN Clinical Reviewer / IDR - Remote (#25310C) Location: Remote Employment Type: Full-time Hourly Rate: $50/hr Position Overview Greenlife Healthcare Staffing is seeking an experienced Registered Nurse Clinical Reviewer (IDR) to join a remote position at a non-... 
    Remote work
    Hourly pay
    Full time
    Work at office
    Flexible hours

    Santa Barbara Cottage Hospital

    New York, NY
    2 days ago
  • $50 per hour

     ...A leading healthcare staffing firm is seeking an experienced RN Clinical Reviewer to work remotely. You'll conduct detailed medical-legal reviews and appeals while maintaining high accuracy and integrity. Key qualifications include a New York State RN license and at least... 
    Remote work

    Santa Barbara Cottage Hospital

    New York, NY
    2 days ago
  •  ...A health organization is seeking a Registered Nurse (RN) to perform clinical review and QIDP work remotely. The ideal candidate will assess medical necessity according to Alabama Medicaid guidelines and possess a current RN license in Alabama, along with a BA/BS in Nursing... 
    Remote work

    Comagine Health

    Sacramento, CA
    3 days ago
  • COMAGINE HEALTH is seeking a registered nurse for Clinical Review and QIDP responsibilities, working remotely from any U.S. location. The role requires an active RN license in Alabama, a BA/BS in Nursing, and at least three years of direct patient care experience. Responsibilities... 
    Remote job
    Work from home

    COMAGINE HEALTH

    Seattle, WA
    1 day ago
  • $28.37 - $35 per hour

     ...through technology, services, and clinical expertise. Our mission is to...  ...Acentra seeks a Clinical Reviewer to join our growing team....  ...Active, unrestricted LPN or RN license in the applicable state...  ...of one year UR and/or Prior Authorization or related experience. Requires... 
    Remote work
    Contract work
    Work at office
    Local area
    Monday to Friday
    Flexible hours
    Shift work
    Weekend work

    Acentra Health, LLC

    McLean, VA
    9 days ago
  • $57 per hour

    ProPivotal Staffing is seeking a Clinical Pharmacist Reviewer to work from home in Massachusetts. This role supports clinical pharmacy services and involves optimizing treatments with healthcare teams. Candidates should have 1-2 years of experience and an active Massachusetts... 
    Remote work
    Hourly pay
    Work from home
    Flexible hours

    ProPivotal Staffing

    Hingham, MA
    2 days ago
  • TEEMA Solutions Group is looking for a Clinical Quality Reviewer to support a large-scale federal healthcare...  ...ideal candidate will have an active RN or LCSW license, at least 3 years of...  ...skills. This role offers flexibility with remote or onsite work options, depending on... 
    Remote job

    TEEMA Solutions Group

    Phoenix, AZ
    2 days ago
  •  ...Registered Nurse with active licensure and minimum 3 years of clinical experience for a remote position. Candidates must have strong clinical...  ...eligible for DoD background clearance. This role involves reviewing medical records, identifying quality issues, and supporting... 
    Remote job

    TEEMA Solutions Group

    Phoenix, AZ
    18 hours ago
  • $50 per hour

     ...Staffing is looking for an experienced Registered Nurse Clinical Reviewer for a fully remote position with an hourly rate of $50. This role involves conducting...  .... Candidates should have an active New York State RN license and 1-3 years of experience in acute care... 
    Remote job
    Hourly pay

    GreenLife Healthcare Staffing

    New York, NY
    18 hours ago
  • $40 - $45 per hour

     ...per week (Mon - Fri) Location :  Remote Summary : The Clinical Reviewer is responsible for conducting clinical reviews of submitted prior authorization (PA) requests and pre-payment...  ...Licensed clinician (e.g., MD/DO, PA, NP, RN) At least 5 years of professional... 
    Remote work
    Hourly pay
    Part time
    For contractors
    Work at office
    Local area

    Neil Hoosier & Associates, Inc.

    United States
    1 day ago
  • $85k - $92k

    TEEMA Solutions Group is seeking a Clinical Quality Reviewer to support a federal healthcare program. This...  .... Candidates must have a valid RN or LCSW license with at least three years...  ...clinical experience. The position may be remote or onsite based on business requirements... 
    Remote job
    Work at office
    Home office

    TEEMA Solutions Group

    Phoenix, AZ
    2 days ago
  • Acentra Health is seeking a remote Registered Nurse (RN) or Licensed Mental Health Professional (LMHP) for a position that involves reviewing medical records and ensuring compliance...  ...license in Virginia and experience in Prior Authorization or Utilization Review. The job... 
    Remote job
    Contract work

    Acentra Health

    Mc Lean, VA
    18 hours ago
  • $85k - $92k

     ...Hourly Equivalent: ~$41-$44/hr Location: Remote Schedule: Must work AZ hours (...  ...HAVE) Active, unrestricted license: RN Minimum 3+ years clinical experience (med/surg and/or behavioral...  ...DESIRED) Clinical Quality / Utilization Review / Case Review experience Experience... 
    Remote job
    Hourly pay
    Day shift

    TEEMA Solutions Group

    Phoenix, AZ
    1 day ago
  •  ...Comprehensive Cancer Centers of Nevada is seeking a Clinical Insurance Reviewer to work remotely in the Southern Nevada area only. The Clinical Reviewer...  ...guidelines for clinical staff Obtains insurance authorization and pre‑certification for imaging, pulmonology and surgical... 
    Remote work
    Work at office

    US Oncology Network-wide Career Opportunities

    Henderson, NV
    4 days ago
  •  ...federal healthcare program to identify a Clinical Quality Reviewer. This role focuses on reviewing...  ...unrestricted license as a Registered Nurse (RN) or Licensed Clinical Social Worker (LCSW...  ...-driven environment Other Information Remote or onsite depending on business needs Must... 
    Remote work
    Work at office
    Home office

    TEEMA Solutions Group

    Phoenix, AZ
    2 days ago
  • $50 - $52 per hour

    Claims Clinical Documentation Reviewer Schedule: 5-10 hours per week. Resource can work...  ...weekends if they prefer. Remote position. Equipment is...  ...FPCC. Knowledge Service Authorization concepts, principles, and...  ...design and implementation, prior authorization functions and... 
    Remote work
    Part time
    Work at office
    Long distance
    10 hours per week

    TALENT Software Services

    Phoenix, AZ
    3 days ago
  •  ...recruiting firm is seeking qualified candidates for a remote RN or LCSW position. Candidates should have at least 3 years of clinical experience in med/surg or behavioral health,...  ...clearance. Responsibilities include reviewing medical records, identifying potential quality... 
    Remote job

    TEEMA Solutions Group

    Phoenix, AZ
    1 day ago
  •  ...quality improvement, and better health outcomes. Our remote workforce collaborates across the country to deliver meaningful...  ...Analysis (ABA) Consultant to support a Medicaid Prior Authorization (PA) program reviewing ABA therapy services. In this role, the consultant... 
    Remote work
    Relief

    Comagine Health

    Seattle, WA
    3 days ago
  • $28.37 - $38 per hour

     ...through technology, services, and clinical expertise. Our mission is to...  ...looking for a PRN Clinical Reviewer - Substance Use (LPCC, LMFT,...  ...needed). The role is also remote within the United States but...  ...Management (UM) OR Prior Authorization. ~ In-depth understanding... 
    Remote work
    Contract work
    Relief
    Work at office
    Local area

    Acentra Health

    McLean, VA
    1 day ago
  • $50 per hour

     ...healthcare recruitment agency is seeking a Registered Nurse Clinical Reviewer for a remote to office-based position in Jericho, NY. This role involves...  ...has a baccalaureate degree in Nursing and a current NY RN license with at least 3 years of related experience. Competitive... 
    Remote job
    Work at office

    GreenLife Healthcare Staffing

    Jericho, NY
    4 days ago
  • $28.37 - $39.19 per hour

     ...through technology, services, and clinical expertise. Our mission is to...  ...impact. Job Summary Clinical Reviewer - Substance Use - LPCC, LMFT, LICSW - PRN (Remote U.S.) Responsible for...  ...Utilization Management (UM) or Prior Authorization experience. In-depth understanding... 
    Remote work
    Hourly pay
    Contract work
    Relief
    Work at office
    Local area

    Acentra Health

    Mc Lean, VA
    3 days ago
  •  ...Avita Health System is hiring a Clinical Documentation Specialist - Nursing (RN) to enhance clinical documentation quality at Avita Ontario Hospital. This full-time position primarily operates remotely, with some required in-person training and physician collaboration.... 
    Remote work
    Full time

    Avita Health System

    Mansfield, OH
    4 days ago
  • $110k - $140k

     ...Clinical Quality Reviewer - BCBA Onos Health's mission is simple but ambitious: ensure every healthcare...  ...management, care review, or prior authorization review for a payer or managed care organization...  ...office (Financial District), remote-first culture Unlimited vacation... 
    Remote work
    Work at office
    Home office
    Flexible hours
    2 days per week
    3 days per week

    Onos Health

    San Francisco, CA
    4 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote RN: Prior Authorization Clinical Reviewer. Be the first to apply!