Remote RN Clinical Reviewer - Healthcare Quality & Compliance
Anacalifornia
- Remote job
Comagine Health is seeking a Clinical Reviewer (RN) to support the Washington Labor & Industries contract in a remote capacity. The role leverages nursing experience to assess medical necessity and care quality from home. You will collaborate with physicians and internal teams, apply evidence-based guidelines, and ensure reviews meet contractual requirements. A WA RN license and 5+ years of direct patient care are preferred. #J-18808-Ljbffr Anacalifornia
$85k - $92k
...4/hr Location: Remote Schedule: Must... ...unrestricted license: RN Minimum 3+ years clinical experience (med/... ...) Clinical Quality / Utilization Review / Case Review... ...federal or government healthcare programs InterQual... ...Ensure compliance with regulatory and...Remote workHourly payDay shift- ...HEDIS RN – Clinical Quality Reviewer Manhattan, NY | 6 Openings | Hybrid | Full-Time HumanEdge Healthcare Staffing is recruiting experienced HEDIS Registered Nurses for clinical... ...0 Church Street. Monday and Friday: Remote. Hours: 8:30 AM–5 PM. Responsibilities...Remote workFull timeContract workWork experience placementMonday to Friday
- ...Leadership, Passion, Quality, Respect, Courage... ..., including remote work opportunities... ...dedicated team.Claims Clinical Documentation... ...Documentation Reviewer reports to the Prepayment... ...knowledge of healthcare State, Federal,... ...assistance to ensure compliance with contractual,...Remote workFull timePart timeInternshipWork at officeWork from homeLong distanceFlexible hours
$59.01k - $81.52k
...technology, services, and clinical expertise. Our... ...efficiency, quality, and impact in... ...looking for a Clinical Reviewer to join our... ...the quality and compliance of service documentation... ...This is a fully remote position where... ...expectations for the healthcare industry. State...Remote workFull timeContract workWork at officeLocal areaFlexible hours$59.01k - $81.52k
...technology, services, and clinical expertise. Our... ...efficiency, quality, and impact in... ...looking for a Clinical Reviewer to join our... ...the quality and compliance of service documentation... ...This is a fully remote position where... ...expectations for the healthcare industry. State...Remote workFull timeContract workWork at officeLocal areaFlexible hours- Comagine Health is seeking an experienced Registered Nurse for a remote Clinical Reviewer role supporting a Washington L&I contract. The position emphasizes evaluating medical necessity, quality, and appropriateness of care using established criteria and guidelines. You...Remote jobContract workWork from home
- Comagine Health, a national nonprofit healthcare consulting organization, seeks a Clinical Reviewer (RN) to support the Washington Labor & Industries contract. This remote role leverages nursing expertise... ...evaluate medical necessity and quality of care, collaborating with...Remote jobContract workWork from home
- ...experienced Registered Nurse to serve as Clinical Reviewer in a remote, Washington-based role. You will assess medical necessity and the quality of healthcare services via prospective, concurrent,... ...decisions. The ideal candidate has RN licensure in Washington and at least...Remote job
- Comagine Health is seeking a Clinical Reviewer (RN) remotely to support Washington state contracts. The role evaluates medical necessity and quality of care, collaborating with physician consultants and internal teams to ensure compliant, evidence-based decisions. The ideal...Remote job
- Lynn Rodens is seeking a skilled Clinical Reviewer/Nurse for a remote role aligned with AZ hours. The position requires active RN license, U.S. citizenship, 3+... ...experience with health plans or large healthcare systems. This role focuses on quality review, PQIs, and collaborating...Remote job
- Comagine Health is seeking a Clinical Reviewer (RN) to evaluate medical necessity, quality and appropriateness of services under the WA L&I contract. This remote role supports case reviews across inpatient, outpatient, and complex imaging by applying evidence-based criteria...Remote jobContract work
- ...Health in Washington State is seeking an experienced registered nurse to join our remote clinical reviewer team. In this role you will assess medical necessity, appropriateness, and quality of care for Washington L&I contracts, applying evidence-based guidelines and...Remote jobContract work
- ...seeking Registered Nurses with 5+ years of clinical experience for a remote data annotation contract role. You will review AI agent conversations across primary care and... ...experience. Join a safety-focused team building healthcare AI. #J-18808-Ljbffr Hippocratic AI Inc.Remote jobContract workFlexible hours
- ...seeking an experienced Registered Nurse to transition into a remote Clinical Reviewer role supporting the Washington L&I contract. The role... ...on evaluating medical necessity, appropriateness, and quality of healthcare services to promote evidence-based care. You will...Remote jobContract work
- Comagine Health, a national nonprofit healthcare consulting organization, is seeking a Clinical Reviewer (Registered Nurse) to support... ...& Industries contract. This remote role focuses on evaluating... ...necessity, appropriateness, and quality of care using evidence-based criteria...Remote jobContract work
- ...is seeking an experienced Registered Nurse to serve as a Clinical Reviewer for the Washington Labor & Industries (L&I) contract. This remote role utilizes nursing expertise to evaluate medical necessity and quality of care, supporting evidence-based decision making. You...Remote jobContract workHome office
- Comagine Health is seeking a licensed RN for a remote Clinical Reviewer role supporting the Washington L&... ..., clinical appropriateness, and quality of healthcare services through prospective,... ..., and document reviews to ensure compliance with contractual and regulatory standards...Remote jobContract work
- Job Title: Preoperative Clinical Review RN About the Client: A specialized... ...dedicated to providing high-quality ophthalmic surgical care. The... ...by an experienced team of healthcare professionals. Overview: Reviews... ...: Night Shift Setup: Remote Why Join STAFFVIRTUAL? Competitive...Remote jobNight shift
- ...viability of the claim for further review in a production environment.... ...Primary Responsibilities: Clinical Case Reviews - 75% Perform... ...to state and federal compliance policies, reimbursement policies... ...Proven working knowledge of the healthcare insurance/managed care...Remote jobContract workWork at officeLocal areaMonday to Friday
$185 per hour
...Enzo Health is a healthcare technology... ...unifies intake, clinical documentation, coding, and quality assurance—enabling... ...and increasing compliance demands. Our... ..., unrestricted RN license in your... ...health QA/OASIS review, utilization review... ...and remote collaboration tools...Remote workContract workReliefShift workWeekend work$34.58 - $51.87 per hour
Remote If you are a current Adventist HealthCare employee, please click this link to apply through your Workday... ...Adventist HealthCare seeks to hire a Clinical Reviewer (RN/PT/OT) who will embrace our... ...to improve documentation for quality reporting based on trends identified...Remote workDaily paidPart timeWork at officeShift workWeekend workDay shift- ...East Coast and Midwest Remote Job Job Description This... ...a remote position. As a Clinical Data Reviewer, you will be joining the... ...organisation, powered by healthcare intelligence. You bring... ...senior reviewers Flag data quality trends, protocol compliance issues, and training...Remote workInternship
$80k - $100k
Clinical Reviewer Registered Nurse (RN) Washington State. Clinical Reviewer Registered... ...Health | Washington State | Remote / Work From Home... ...in clinical review and healthcare quality. Why Comagine Health? At... ...Operational Support Support compliance with Washington L&I...Remote workFull timeContract workLocal areaWork from homeHome office$110k - $140k
...Clinical Quality Reviewer - BCBA Onos Health's mission is simple but ambitious: ensure every healthcare dollar goes toward delivering the highest quality... ...charts for quality and compliance Strong written communication... ...(Financial District), remote-first culture ~...Remote workWork at officeHome officeFlexible hours2 days per week3 days per week$70k - $120k
...Fully Remote: Clinical Documentation Specialist Facilitate the... ...and retrospective reviews of medical records to... ...patient care. Educate healthcare providers on the importance... ...improvement. Ensure compliance with regulatory requirements... ...Registered Nurse (RN) with a current...Remote workLocal areaMonday to Friday- ...Registered Nurse: Review and EvaluationAre... ...Pennsylvania's premier Quality Improvement... ...integrity through compliance management. Here,... ...care, and influence healthcare outcomes on a meaningful... ...You'll Do:Conduct clinical reviews and ensure... ...Registered Nurse (RN) licenseStrong...Remote workWork from home
- ...Adventist HealthCare seeks a Clinical Documentation Specialist to extend God’... ...healing. The role focuses on reviewing medical records to ensure... ...staff to improve quality and compliance. Responsibilities include... ...adherence to CMS guidelines, with a remote day #J-18808-LjbffrRemote work
- ...a part-time, PRN Dental Hygienist Clinical Content Reviewer. This remote North America role supports clinicians... ...with data teams to ensure high-quality clinical information at the point of... ...flexibility and a strong commitment to transforming healthcare. #J-18808-Ljbffr OsmosisRemote jobPart timeRelief
- ...scalable solutions and clinical expertise help... ...This position is REMOTE within US Only -... ...) The Clinical Reviewer supports the... ...determination activities in compliance with CMS... ...physicians, nurses, quality teams, customer... ...Proficiency with healthcare technology platforms...Remote workWork at officeImmediate startMonday to FridayFlexible hoursAfternoon shift
- ...compensation medical-legal review, where our agentic... ...them. You will be the clinical conscience of the product... ...findings. Support customer quality reviews and respond to... ...we look for Active RN license and 5+ years of... ...opportunity employer. Location: Remote (United States)...Remote workFull timeFlexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote RN Clinical Reviewer - Healthcare Quality & Compliance. Be the first to apply!


