Remote RN Clinical Quality Auditor for Health Plans
$72.8k - $130kNACBA
- Remote job
NACBA is seeking a Senior Clinical Quality Auditor to support health care management. This role involves auditing processes and ensuring compliance with established guidelines. The ideal candidate holds an unrestricted RN license and has over three years of experience in quality improvement within managed care settings. We offer a competitive salary between $72,800 to $130,000 annually, based on experience and qualifications. You can work remotely from anywhere in the U.S., fostering a collaborative team environment. #J-18808-Ljbffr NACBA
$72.8k - $130k
Texas Health Institute is looking for a Senior Clinical Quality Auditor to support care management and quality auditing processes.... ...Applicants must hold a current RN license and have at least 3 years... ...improvement. The position offers remote work from anywhere in the U.S.,...Remote jobHealth Insurance$72.8k - $130k
At UnitedHealthcare, the Senior Clinical Quality Auditor role focuses on ensuring compliance... ...the flexibility to work remotely across the U.S. Key qualifications include an active RN license and substantial experience in health plan quality improvement. The position...Remote jobHealth Insurance$72.8k - $130k
UnitedHealthcare is seeking a Senior Clinical Quality Auditor to support care management operations and... ...initiatives. Candidates must have a current RN license and experience in health plan quality improvement. The position offers remote work flexibility across the U.S. and a...Remote jobHealth Insurance$72.8k - $130k
UnitedHealthcare is hiring a Senior Clinical Quality Auditor responsible for supporting... ...and operations. This remote position requires strong... ...communication, and experience in health plan quality improvement. The... ...must hold a valid RN license and have at least 3...Remote jobHealth Insurance$72.8k - $130k
UnitedHealthcare is hiring a Senior Clinical Quality Auditor to enhance care management... ...must possess an active RN license and have extensive... ...clinical programs. You can work remotely from anywhere in the U.S.... .... Join us to help transform health care into a more affordable...Remote job$93.4k - $116.8k
Overview Are you an experienced RN with a strong background in Quality including quality of care reviews, incident investigation, and regulatory compliance? VNS Health Plans is seeking a seasoned clinical professional to play a critical role in reviewing and resolving...Health InsuranceWork experience placementFlexible hours$99k - $124k
Clinical Quality Auditor, Nurse Practitioner United States (Job Title) Benefits Hybrid-Remote Flexibility - Work from home while fulfilling in-person... ...and disability insurance, health and flexible spending... ...review patient files, care plans, and interactions against...Remote workHealth InsuranceWork at officeWork from homeFlexible hours- ...Description Job Description Fully remote- Must have state of MI unrestricted RN license. You will perform... ...~ May establish care plans and coordinate care through the health care continuum including... ...skills (Microsoft office) Clinical experience in ICU, ER, or medical...Remote workHealth InsuranceWork at officeFlexible hours
$67.3k - $93.05k
Acentra Health, LLC is seeking a Clinical Assessor for a hybrid role, operating primarily in North Carolina.... ...candidate will hold a valid NC or Compact RN license and have a minimum of two... ...benefits package including health plans and paid time off. #J-18808-Ljbffr Acentra...Remote jobHealth Insurance- ...Senior Quality Improvement Specialist (RN) Location: NYCLAY (100% remote) Duration: 45 W, 3 D Client: Molina... ...component of near real-time clinical decision-making.... ..., vendors and HEDIS auditors. Assists the... ...years experience in health plan quality improvement,...Remote workHealth Insurance
- ...available Overview: Sentara Health Plansis hiring a Clinical Compliance Consultant/LPN/RN/LCSW/LPC - Remote in Virginia! Status: Full-... ...Experience 1 year of quality, regulatory, compliance, accreditation... ...highly preferred Health plan experience preferred...Remote workHealth InsurancePermanent employmentFull timeTemporary workShift work
$67.3k - $70k
Acentra Health is seeking a Registered Nurse Clinical Assessor in West Virginia to perform medical assessments for Medicaid... ...local travel and requires a valid RN license and ASN degree. The RN will... ...offers benefits including health plans, paid time off, and educational...Remote jobHealth InsuranceLocal area- Ethos is looking for an RN Home Care Supervisor in the City of White Plains, NY... ...York, a BSN, and at least 3 years of clinical experience. The position offers an excellent benefits package, including health care, retirement plans, and flexible work schedules. #J-18808...Remote jobHealth InsuranceFlexible hours
- ...: Position Description: RN-Specialty Location: Hybrid... ...to come on-site for monthly clinic meetings ** Mercy Heart &... ..., and matched retirement plans for team members working 32+ hours... ...Mercy, Days, clinics, outpatient, no weekends, nurse, hybrid, remoteRemote workHealth InsuranceFull timeWork from home
- ...Practitioner with Esperta Health, you'll elevate the... ..., mentorship, and clinical excellence come... ...position combines remote clinical... ...and partner to the RN field team. Key... ...assessments, and care plans for accuracy and clinical... ...treatment plans Support quality assurance,...Remote workHealth InsuranceFull timeTemporary work
$67.3k - $70k
...Company Overview Acentra Health exists to empower... ...technology, services, and clinical expertise. Our mission... ...is looking for a RN Clinical Assessor to join... ...West Virginia, combining remote work from home with field... ...comprehensive health plans, paid time off, retirement...Remote workHealth InsuranceWork at officeLocal areaFlexible hours$60 - $70 per hour
...Flexible schedule Position: RN Clinical Supervisor (Part-time, Remote/Flexible) Compensation: ~ $60-$70... ...be creating and managing a plan of care for individual patients. You... ...Title 22 HHA regulations and CDPH Home Health Agency standards • Accreditation Commission...Remote workHealth InsuranceHourly payFull timePart timeWork at officeFlexible hoursShift work$85k - $92k
...41-$44/hr Location: Remote Schedule: Must work AZ... ...license: RN Minimum 3+ years clinical experience (med/surg and/or behavioral health) Strong clinical documentation... ...HIGHLY DESIRED) Clinical Quality / Utilization Review... ...with health plans or large healthcare systems...Remote jobHealth InsuranceHourly payDay shift$31 - $35 per hour
...Clinical Review & Correspondence RN The Clinical Review & Correspondence RN plays... ...you will help support high-quality care, regulatory compliance... ...correspondence within a health plan environment Minimum of... ...This is a 100% remote role, and requires robust...Remote workHealth InsuranceFull timeFlexible hoursShift work- ...Clinical Supervisor, UM Denial Compliance Location:... ...Position Type: Hybrid (85% remote, 15% onsite in Burbank,... ...in ensuring a high-quality, efficient, and compliant... ..., accreditation, and health plan standards for associated... ...Registered Nursing Program; RN preferred. Minimum...Remote workHealth Insurance
$95k - $100k
...Job Description: Home Health Clinical Team Specialist (RN) Full-time or PRN schedules available Remote (MA Licensed) At Elara Caring... ...directly impacts compliance, quality, and reimbursement. This... ...work: OASIS reviews + 485 plan of care review/approval ~...Remote workHealth InsuranceFull timeReliefWork at officeFlexible hours$36.66 - $48.48 per hour
...At National Jewish Health, Registered Nurses are... ...care teams to assess, plan, and implement high-quality nursing care while supporting... ...This role emphasizes clinical excellence,... ...Colorado Registered Nurse (RN) License and current... ...regional office and remote employees. Health...Remote workHealth InsuranceFull timePart timeWork experience placementCurrently hiringWork at officeLocal areaWorldwideMonday to FridayWeekend work- ...Quality Improvement Stars Clinical RN Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department... ...for Medicaid STAR Health Insurance Marketplace Plans that offer individual health coverage that includes...Remote workHealth InsuranceWork experience placementWork at office
$77k - $80k
Overview Acentra Health exists to empower better health outcomes through... ...technology, services, and clinical expertise. Our mission is to... ...Statewide in North Carolina (remote/home office; travel to assessment... ...providers; conduct service plan reviews as needed. Submit completed...Remote workHealth InsuranceHome office$34 - $48.62 per hour
...Adult Immediate Care Clinic (ICC) at National Jewish Health is seeking a... ...Summary Accurately plans and provides professional... ...or Procedural RN is responsible and accountable... ...[SPP 13]. # Quality of Practice: Contributes... ...regional office and remote employees. Health...Remote workHealth InsuranceFull timePart timeWork experience placementWork at officeLocal areaImmediate start- ...Medical Review Clinical Appeals Auditor (RN) In October 2025, Machinify acquired... ..., and efficiency to health plans. Deployed by over 75 health... ...deliver industry-leading speed, quality, and accuracy. We're... ...to work independently in remote setting with minimum supervision...Remote workHealth InsuranceFlexible hours
$52.5 per hour
...RN Clinical Manager / Clinical Consultant (RN or MSW) – California... ..., project continuation, and health plan needs) Schedule: 9:00 AM – 5... ...PM PST, Monday–Friday Model: Remote-First (with limited field visits... ...when requested Quality, Compliance & DHCS Requirements...Remote workHealth InsuranceContract workLocal areaMonday to Friday$85k - $106.3k
...assesses needs, gives appropriate clinical recommendations, and guides... ...every Saturday 9AM - 5PM (REMOTE). What We Provide... ...off and 9 company holidays Health insurance plan for you and your loved ones,... ...nurses to the Contact Center RN role and responsibilities...Remote workHealth InsuranceWork experience placementFlexible hoursShift work- ...Company: Comagine Health is a national, mission... ...in health care quality consulting and quality... .... Our talented remote workforce spans the... ...Retirement savings plan with employer contribution... ...is an active RN and based in Alabama... .... The Supervisor, Clinical Review plays a critical...Remote workHealth InsuranceContract work
$50k
Department Overview The Clinical Documentation Specialist will... ...conditions, treatments and care plans within the health record to accurately... ...physicians to ensure high quality documentation that supports... ...review of patient records in a remote setting. The Registered Nurse...Remote workHealth InsuranceFull timePart time
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