Remote Clinical Review Nurse - Prior Authorization
SPECTRAFORCE
A healthcare staffing company is seeking a Clinical Review Nurse for Prior Authorization Review. This remote role demands conducting reviews, collaborating with healthcare teams, and ensuring compliance. Candidates need an active RN license and 2–4 years experience in Prior Authorization review. Strong documentation and communication skills are essential for maintaining high-quality care. This 12-month contract position offers flexibility in the PST time zone. #J-18808-Ljbffr
- ...A healthcare staffing company is seeking a Clinical Review Nurse for Prior Authorization Review. This remote role demands conducting reviews, collaborating with healthcare teams, and ensuring compliance. Candidates need an active RN license and 2–4 years experience in...Remote workContract work
- ...Position Title: Clinical Review Nurse - Prior Authorization Assignment Duration: 6 months; potential to extend/convert Work Schedule: OT as needed... ...- Fri / Possible holiday shifts Work Arrangement: Remote-Central Time Zone preferred Responsibilities:...Remote workShift work
$44 per hour
...Clinical Review Nurse - Prior Authorization Various, NV Clinical Review Nurse - Prior Authorization Various, NV All On-site Location: Fully Remote – Prefer Candidates reside in NV, but can reside elsewhere if they have an NV RN License. SHIFT: Training...Remote workPermanent employmentContract workLive inShift work- ...CLINICAL REVIEW NURSE - REMOTE ARC Group has multiple positions open for Clinical Review Nurses!... ...must currently have PERMANENT US work authorization. Sorry, but we are not considering... ...care which may include cases requiring prior authorization, complex pre-payment...Remote workPermanent employmentWork at officeLocal area
- ...Position Purpose: Analyzes all prior authorization requests to determine... ...from an Accredited School of Nursing or Bachelor's degree in Nursing... ...experience. Clinical knowledge and ability to analyze... ...medical necessity and clinical reviews of authorization requests to...Remote work
- ...Description: Manager of Clinical Utilization... ...CAPosition Type: Hybrid (85% remote, 15% onsite in... ...daily tasks, performance reviews, and any necessary disciplinary... ...Registered Nursing Program; RN preferred... ...Minimum of five years in prior-authorization, appeals & grievance,...Remote workPermanent employmentFull timeTemporary workFlexible hours
$71.1k - $97.8k
...Skills Research Institute is seeking a Pre-Authorization Registered Nurse to join their team. This role involves reviewing prior authorization requests to ensure appropriate... ...licensed RNs with a minimum of two years clinical experience. The compensation ranges from $7...Remote workWork from home$62.4k - $93.6k
...Clinical Review Nurse - Prior Authorization The Clinical Review Nurse – Prior Authorization is responsible for reviewing and processing prior authorization requests to ensure medical necessity, appropriate level of care, and compliance with health plan and regulatory requirements...- ...Elevance Health is seeking a Clinical Review Nurse I - Medicare Part B to review claims for medical necessity under Part B policies. The role is remote with required in-person training and follows a 8 am–5 pm EST Monday–Friday schedule. It’s part of Wellpoint Federal,...Remote workMonday to Friday
- ...Gainwell Technologies seeks a Clinical Quality Nurse Reviewer, Sr. Specialist to perform quality assurance audits of medical records and reviews... ...and contract methodologies across multiple review types. Remote, US-based, full-time role with up to 10% travel; ideal candidates...Remote workFull timeContract work
- ...A healthcare organization is seeking a Clinical Review Nurse – Concurrent Review to perform utilization management functions remotely. The role requires conducting concurrent reviews, collaborating with medical teams, and ensuring quality healthcare outcomes. Candidates...Remote workWork at office
- ...Clinical Medical Review NurseAmpcus Inc. is a certified global provider of a broad range of Technology... ...).Qualifications:Registered Nurse (RN) – active state or compact license... ...professionalism and a collaborative mindset.Remote work environment with minimal physical...Remote work
$36 - $40 per hour
Utilization Review Registered NurseThis role focuses on performing... ...Review Registered Nurse evaluates clinical information, applies medical... ...to support care decisions, authorizations, discharge planning, and smooth... ...position is 100% remote, with a preference for candidates...Remote workContract workTemporary workMonday to FridayShift work$34 - $40 per hour
...Clinical Review Nurse (Remote)Make a meaningful impact on patient care from the comfort of your home.We are seeking an experienced Clinical Review Nurse (RN) to join our growing healthcare team. In this fully remote role, you will evaluate medical records, determine medical...Remote workContract workTemporary work- ...Role : Clinical Medical Review Nurse Location : Canton, MD (Hybrid - 2-3 days onsite per week) Type: Contract About the Role:... ...Nurses . This is a hybrid contract position requiring both remote work and regular onsite presence at the Canton, MD office...Remote workContract workWork at office2 days per week3 days per week
$27.02 - $48.55 per hour
...Purpose: Performs concurrent reviews, including determining member... ...medically necessity based on clinical policies and guidelines Reviews... ...from an Accredited School of Nursing or Bachelor's degree in... ...flexible approach to work with remote, hybrid, field or office work...Remote workHourly payFull timePart timeWork at officeFlexible hours- ...Job Title Location: 100% Remote – Any US State Shift: Fri-Sat... ...correspondence letters based on review outcomes in accordance with... ...for improvement. Performs clinical review of outcomes including... ...from an accredited school of nursing or A.D. or bachelor's in nursing...Remote workLocal areaShift work
- ...team! As a Utilization Review Nurse, you will utilize your... ...thinking skills, clinical expertise and judgement... ...require medical necessity authorization. We are seeking... ...preferred. In addition to prior experience, the ideal... ...skills. This is a fully remote position with multiple...Remote workFull timeLocal areaShift work
- ...Position Title : Clinical Review Nurse - Concurrent Review Work Location : Remote - Central, Mountain or Pacific preferred Assignment Duration : 6 months... ...of care remains medically appropriate. ~ Authorization documentation: Complete authorization activities...Remote workTemporary work
$36 - $40 per hour
...Utilization Review Registered Nurse This role focuses on performing comprehensive... ...Nurse evaluates clinical information, applies medical... ...to support care decisions, authorizations, discharge planning, and... ...This position is 100% remote, with a preference for candidates...Remote workContract workTemporary workMonday to FridayShift work- ARC Group is seeking a Clinical Review Nurse for a 100% remote position. The role focuses on reviewing health claims, determining medical necessity, and ensuring alignment with national and local policies and standards of care. Must hold a nursing degree and RN license,...Remote jobLocal area
$21 per hour
...viability of the claim for further review in a production environment.... ...Key Responsibilities: Clinical Case Reviews - 75% Perform... ...Coding Certificate and/or Nursing Licensure Complete compliance... ...could change to hybrid or remote after the 8-week training....Remote workHourly payFull timeContract workTemporary workMonday to Friday$85k - $92k
...contract to hire. Position Overview Job Title: CLINICAL QUALITY REVIEWER (RN or LCSW) Location: USA- Remote in approved states Overview: TEEMA is... ...: Active, unrestricted license as a Registered Nurse (RN) or Licensed Clinical Social Worker (LCSW) Minimum...Remote workHourly payContract workWork at officeHome office- ...Title: Clinical Review Nurse Concurrent Review Assignment Duration: 6 Months Possibility... ...Yes Contract to Hire Work Location: Remote Business Unit/Health Plan: Medicare... ...Review is responsible for analyzing authorization requests and determining the medical...Remote workContract workMonday to FridayShift workWeekend work
$78k - $88k
...Summary We are seeking a skilled Utilization Review Nurse to conduct prior authorization, prospective, concurrent, and retrospective reviews for medical... ...necessity and appropriateness of services, following clinical criteria, coverage policies, and contract guidelines....Remote workFull timeContract workWork at officeWork from homeFlexible hours- ...Clinical Nurse ReviewerAs one of the fastest growing Independent Physician Associations... ...currently have an opening for Clinical Nurse Reviewer. The Clinical Nurse Reviewer will... ...Medical Director(s) high cost prior authorization requests as well as hospital readmissions...Work experience placementFlexible hours
$70.8k - $123.8k
...Clinical Nurse Auditor CGI is one of the world's largest independent... ...documentation skills to review inpatient and outpatient claims... .... This position is remote within the United States, and... ...reasonable and necessary services, prior authorization validation, clinical...Remote workWork at office$78k - $88k
...Gainwell Technologies is seeking a skilled Utilization Review Nurse to perform prior authorization across prospective, concurrent, and retrospective reviews for medical necessity, documenting findings and ensuring policy compliance. This home-based role supports providers...Remote work$1,949.74 per month
...Travel Offering Nursing Profession Registered... ...Specialty Utilization Review Job ID 17979666... ...Job Description Remote Utilization Review RN responsible... ...medical necessity determinations, prior authorizations, continued stay reviews, and...Remote workWeekly payShift work- ...Management Location: 100% Remote Schedule: M-F 9:00am... ...Assess and analyze clinical service requests (e.g... ...eligibility Process prior authorization determinations within... .../utilization review and other utilization... ...IL State Registered Nursing (RN) license in good...Remote workContract work
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