Remote RN: Medical Necessity Reviewer I
$33.92 - $58.15 per hourElevance Health
- Remote job
Elevance Health is seeking a Nurse Reviewer I to conduct medical necessity reviews and preauthorization for diagnostic imaging services. This virtual role offers flexibility while requiring in-person training sessions as necessary. Applicants must have an AS in nursing, a current RN license, and a background in clinical nursing or utilization management. Elevance Health provides a competitive salary range of $33.92/hr - $58.15/hr and a robust benefits package including equity stock options and a 401k plan. #J-18808-Ljbffr Elevance Health
- ...Friday, 8:00 AM – 5:00 PM Location : Remote (U.S. – Work from home) Remote... ...a dedicated Registered Nurse (RN) to join our Medical Review team . This role involves conducting... ...clinical expertise to assess medical necessity, appropriateness, and reimbursement...Remote workFull timeFor contractorsWork at officeHome officeMonday to Friday
- ...A leading Independent Review Organization is seeking Board-Certified Psychiatrists with a New York medical license for a fully remote opportunity. This role involves conducting medical necessity reviews, allowing you to maintain your active practice while enjoying flexibility...Remote work
- ...UnitedHealth Group is looking for a Secondary Review Nurse in Indiana. This role requires a current RN license and involves evaluating clinical requests for Home... ...and Community-Based Services. The position offers remote work flexibility and responsibilities include...Remote workWork from home
- ...consulting firm is seeking a dedicated Registered Nurse (RN) to join the Medical Review team. This role involves conducting pre- and post-payment... ...communication skills are essential. This position offers a remote work environment with all necessary equipment provided. #J...Remote work
- ...patient outcomes. Our talented remote workforce spans the country and plays... ...Overview We are seeking an RN to perform Clinical Review work and QIDP reviews work. Team... ...criteria and guidelines to determine the medical necessity of health care services. Intermediate...Remote workContract work
- ...South Carolina is looking for a qualified applicant to perform medical reviews and support medical claims processing. The role involves... ...established clinical guidelines. Applicants must hold an active RN license and have at least two years of clinical experience. The...Remote workFull time
$67.7k
...A specialized consulting firm is seeking a Medical Claims Reviewer to conduct medical reviews and provide guidance on claims. This remote role requires an active RN license, a bachelor's degree in nursing, and at least five years of clinical experience. Ideal candidates...Remote workFull timeMonday to Friday- ...Astyra Corporation is seeking a remote position focusing on clinical expertise to review medical records to meet contract requirements. The role requires an active... ...of experience in Utilization Review and medical necessity review, as well as excellent critical thinking...Remote workContract workFlexible hours
- ...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... ...applying Medicaid criteria to determine medical necessity, completing reviews within established timelines...Remote job
- ...Territorial Epidemiologists is seeking an RN to perform Clinical Review and QIDP reviews. This role is primarily remote, requiring a reliable internet connection and... ...Medicaid program criteria to determine the medical necessity of services, completing reviews within...Remote job
- ...Epidemiologists is seeking a Registered Nurse (RN) for a dual role performing Clinical Review work and Quality Improvement... .... The position is primarily remote, requiring reliable internet... ...Medicaid criteria, reviewing care necessity, and responding to client needs. Candidates...Remote job
- Southcarolinablues in South Carolina is looking for a Medical Reviewer II. This remote position involves performing medical reviews, making coverage... ...documenting all decisions. Candidates must hold an active RN licensure and have two years of clinical experience. We provide...Remote job
- 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 job
- Integrated Resources, Inc. is seeking a Clinical Care Reviewer to perform medical necessity reviews as directed by the unit Supervisor. The role involves using clinical knowledge to evaluate service requests and ensure compliance with medical management guidelines. This...
- A leading staffing firm is seeking a Clinical Care Reviewer UM for a three-month position with potential for extension. The role involves conducting medical necessity reviews and requires a Registered Nurse license along with excellent communication and problem-solving...
- A leading staffing firm is seeking a Clinical Care Reviewer to conduct thorough medical necessity reviews under the supervision of a unit supervisor. The role requires a Registered Nurse with at least 3 years of experience in a clinical setting, focusing on ensuring that...
$85k - $92k
...Equivalent: ~$41–$44/hr Location: Remote Schedule: Must work AZ hours (... ...Active, unrestricted license: RN Minimum 3+ years clinical... ...Clinical Quality / Utilization Review / Case Review experience Experience... ...WHAT THEY ACTUALLY DO) Review medical records for quality, safety,...Remote workHourly payDay shift- ...active licensure and minimum 3 years of clinical experience for a remote position. Candidates must have strong clinical documentation... ...be eligible for DoD background clearance. This role involves reviewing medical records, identifying quality issues, and supporting quality...Remote work
$50 per hour
...Overview RN Clinical Reviewer / IDR - Remote (#25310C) Location: Remote Employment Type: Full-time Hourly Rate: $50/hr Position Overview Greenlife... ...York. Responsibilities include conducting comprehensive medical-legal reviews and appeals for a respected non-profit organization...Remote workHourly payFull timeWork at officeFlexible hours- ...extension) *Note: Candidates can be remote but must have an active unrestricted Massachusetts RN License Job Summary The Clinical Reviewer, Precertification RN, is a licensed Registered... ...is responsible for determining medical necessity and benefit coverage for members. The...Remote workContract workWork at officeWork from home
- ...Volunteer Medical Reviewer (Nurse / Medical Professional) Organization: Maya’s Hope Location: Remote Time Commitment: Flexible (estimated 2–5 hours per week - flexible) Position Type: Volunteer About the Role Maya’s Hope is seeking a compassionate...Remote workFlexible hours
$67.7k
...trusted partner in innovation. Medical Claims Reviewer Overall Purpose of the... ...guidelines. Determines medical necessity and appropriateness and/or reasonableness... ...: Active, unrestricted RN licensure from the United... ...to Friday Work Location : remote within three hour driving...Remote workFull timeContract workFor contractorsLive inWork at officeWork from homeHome officeMonday to FridayFlexible hoursShift work$38.46 - $43.27 per hour
...Clinical Reviewer As the Clinical Reviewer, you will... ...receipt of the electronic medical records, communicate... ...knowledge for medical necessity and quality of care issues... .... Ability to work remotely one day per week after... ...required (open to any RN state license). Graduate...Remote workHourly payFull timeFor contractorsWork at office1 day per week$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$53 - $59 per hour
...offer the quality of a premier academic medical center and the caring of a community hospital... ...Clinical Documentation Specialists will review the documentation and coding sequence for... ...be detail orientated. *Position is fully remote, but needs to be available to come onsite...Remote workHourly payDaily paid$70k - $120k
...Fully Remote : Clinical Documentation Specialist Job Description Facilitate... ...caregivers. Perform concurrent and retrospective reviews of medical records to ensure accurate documentation... ...Registered Nurse (RN) with a current license from any state....Remote workLocal areaMonday to Friday- ...growing team of expert clinical reviewers. In this role, you will apply... ...chiropractic care. This is a remote telework opportunity that... ...responsibilities will include reviewing medical records, preparing clear and... ..., diagnosis, and medical necessity. Join a team that values your...Remote workFor contractors
- The Council of State and Territorial Epidemiologists is looking for a remote RN to perform clinical review and QIDP work. This position requires an active RN license in Alabama and a minimum of 3 years of direct patient care experience. Your responsibilities include applying...Remote jobFlexible hours
- Stryker Corporation is seeking an RN for Clinical Review and QIDP reviews, working remotely with a focus on applying Alabama Medicaid criteria to healthcare services. The ideal candidate must have a BA/BS in Nursing and be an active RN in Alabama. Key responsibilities include...Remote job
$85k - $89k
...and evaluating potential quality issues. Candidates must have 3 years of clinical experience and a relevant degree. Benefits include medical coverage, 401(k) matching, and paid time off. Salary ranges from $85,000 - $89,000 annually, depending on experience and location....Remote job
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote RN: Medical Necessity Reviewer I. Be the first to apply!
- neuro icu registered nurse Miami, FL
- new grad rn Miami, FL
- nicu rn Miami, FL
- registered nurse nursing home Miami, FL
- rn observation unit Miami, FL
- rn hospice Miami, FL
- outpatient registered nurse Miami, FL
- rn evening shift Miami, FL
- home health rn case manager Miami, FL
- ambulatory care rn - registered nurse Miami, FL

