Quality Review Nurse, RN Remote
Inland Empire Health Plan
Inland Empire Health Plan is seeking a Provider Quality Review Nurse, RN to manage quality assurance responsibilities. This role involves investigating care incidents and coordinating with healthcare facilities to ensure quality care delivery. The position requires a Bachelor's degree in Nursing, an active RN license, and a minimum of three years in healthcare quality management. Successful candidates will have excellent analytical and communication skills, and the role supports telecommuting options. #J-18808-Ljbffr
$35 - $45 per hour
...Registered Nurse (RN) | Utilization Review Location: Corpus Christi, TX Agency: Mindlance Health... ...contact and will include 80% travel. Remote role. Will require a driver’s license... ...travelers be an infectious agent of quality care wherever they go. Join...Remote workQualityHourly payFull timeContract workImmediate startShift work3 days per week- ...Solutions is seeking a Utilization Review Nurse to join their team in a fully remote role. The ideal candidate must be... ...Practitioner (LPN) or Registered Nurse (RN) with strong critical thinking... ...clinical reviews, assisting in quality improvement, and resolving patient...Remote workQuality
$77.91k - $116.86k
Alignment Healthcare LLC is seeking a remote Inpatient Review Nurse to assist patients through the continuum of care while ensuring safety and quality. The role requires effective communication... ...must hold an active California LVN or RN license. The salary range is $77,905.0...Remote jobQualityFull timeMonday to Friday$91.25k - $120.91k
...we believe the highest quality of care should be delivered... ...of case assignments Reviewing escalated issues... ...setting Bachelor's degree in Nursing from an accredited institution... ...Registered Nurse (RN) license issued by the... ...for telecommuting/remote work location upon completing...Remote workQualityTemporary workWork experience placement- ...POSITION SUMMARY: The Utilization Review Registered Nurse (UR RN) is a key contributor to the delivery... ...transitions to appropriate levels of care. • Quality Assurance and Compliance o Ensure... ...) certification as required for facility based staff; optional for remote staff.Remote workQualityWork at office
$30 - $38 per hour
...Job Summary We are seeking Utilization Review Nurse RN to join our team on a part‑time basis,... ...and NCCN. Ability to meet productivity, quality, and turnaround times daily. Ability to... ...communication skills to successfully perform in a remote healthcare environment. Ability to...Remote workQualityHourly payFull timePart timeWork at officeMonday to FridayWeekend work- ...Registered Nurse (RN) – Case Manager & Utilization Review Nurse Wichita, United States | Posted on 05/25/2026 We are... ...-bedside setting while supporting quality member outcomes, appropriate... ...telephonically;however, this isnota remote position. Applicant must be ableto...Remote workQualityMonday to FridayFlexible hours
$27.02 - $48.55 per hour
...flexibility. Location: Remote. Must work PST hours. * Must hold RN license in California.... ...Purpose: Performs concurrent reviews, including determining... ...level of care Reviews quality and continuity of care by... ...an Accredited School of Nursing or Bachelor’s degree in Nursing...Remote workQualityHourly payFull timePart timeWork at officeFlexible hours- ...Deercreekseniorliving is seeking a Quality Assurance Registered Nurse (RN) for Home Health to ensure clinical... ...quality and regulatory compliance. This remote position requires expertise in OASIS... ...work closely with clinical teams, review assessments, and participate in quality...Remote workQuality
- ...A national healthcare organization is searching for Clinical Utilization Review Nurses (RN) based in Alabama. This full-time, remote position involves assessing the medical necessity and quality of healthcare services. Candidates must have a BA/BS in Nursing and an active...Remote workQualityFull time
- ...hiring a Clinical Care Manager to oversee high-quality, patient-centered care through Utilization Review. The role requires an active RN license in Illinois and significant... ...providers. This position offers the flexibility of remote work while supporting professional growth...Remote workQuality
$75.77k - $113.66k
...company is looking for a Medical Management Nurse to review complex cases and utilize nursing... ...collaborating with healthcare providers to ensure quality member outcomes. Candidates must possess... ...management experience, and an active RN license. The salary range for this...Remote workQuality$91.25k - $120.91k
...professional for a short-term assignment focused on quality assurance and management. The role includes reviewing cases, providing recommendations, and working... ...in healthcare settings and a bachelor's degree in nursing. The pay range for this position is between $91,24...Remote workQualityTemporary work- ...A leading healthcare organization is seeking a remote RN to ensure appropriate administration of hospital resources and quality care. Responsibilities include reviewing patient care levels and utilizing Interqual Criteria for inpatient hospitalizations. The ideal candidate...Remote workQuality
$49.14 per hour
...Dignity Health is seeking a Utilization Review Nurse to supervise clinical decision-making and ensure resource utilization compliance. Responsibilities include reviewing medical records, implementing utilization review principles, and liaising with care coordinators and...Remote workQualityHourly pay- ...A premier medical services provider is seeking a self-driven Registered Nurse (RN) as a Clinical Quality Assurance Coordinator. This remote role involves reviewing peer quality assurance reports, ensuring compliance with standards, and managing client specifications. Applicants...Remote workQuality
$77.91k
...Healthcare USA, LLC is seeking an Inpatient Review Nurse to join its remote Utilization Management team. This... ..., coordinating care, and ensuring quality and cost-effective patient outcomes.... ...management and licensing as an LVN or RN in California. The role offers a pay...Remote workQuality- ...regional healthcare provider in Houston is seeking a Utilization Management Review Nurse. This role involves evaluating the appropriateness of medical services based on necessity and promoting quality care outcomes. The candidate must have a Bachelor's in Nursing and hold...Remote workQualityFlexible hours
- ...Village Center for Care, Inc. is seeking a self-motivated RN for the role of Utilization Review Nurse in a full-time, hybrid position located in the New... ...responsible for assessing member needs and ensuring high-quality health care services. Key qualifications include a...Remote workQualityFull time
- ...A healthcare staffing firm is seeking a skilled Utilization Review RN to join their team. This fully remote position requires a valid PA RN license and prior experience in insurance utilization review. Responsibilities include conducting clinical reviews, applying evidence...Remote workQuality
- ...yourcommission is looking for a Utilization Management Review Nurse to evaluate and ensure the effectiveness of medical services in Texas... ...Management. The position requires flexibility in work hours and participation in quality improvement initiatives. #J-18808-Ljbffr...Remote workQualityFlexible hours
$80k
...organization is seeking a full-time Clinical Reviewer to enhance the lives of older adults and... ...analyses, and writing reports. Remote work is primarily allowed, with occasional... ...Candidates must be licensed as a Registered Nurse in Nebraska and have experience in nursing...Remote workQualityFull time- ...Humana is offering a remote internship for a Utilization Management... ...Behavioral Health Registered Nurse (RN) Intern. This role supports... ...Medicaid team, focusing on clinical reviews and patient care. Candidates... ...reviews, documentation, and quality assurance. The position...Remote workQualityInternshipWork at officeWeekday work
- ...MVP Health Care is seeking a remote Sub-Acute RN UM Reviewer to join its Utilization Management team. In... ...Medicare guidelines and support high-quality patient outcomes. The role requires current... ...in NY & VT and a solid background in nursing with experience in sub-acute care...Remote workQuality
$36.27 - $56.77 per hour
...Elevance Health is looking for a Nurse Reviewer I in Walnut Creek, CA, allowing for virtual work... ...collaborating with healthcare providers to ensure quality member outcomes. Candidates must have an AS in nursing and possess a current RN license, with a minimum of 3 years of...Remote workQualityFull time- ...Health Care Inc. is looking for a Utilization Review Nurse in New York. This role requires a strong... ...and utilization management to ensure quality, cost‑efficient medical outcomes. Responsibilities... .... Candidates must have a Compact RN License and at least 3 years of clinical...Remote workQuality
- ..., DC is seeking a DME Medical Reviewer to ensure compliance with nursing standards and provide comprehensive... ...candidate must hold an active RN license and have at least two... ...meetings, and performing quality audits. The role emphasizes remote work capabilities and adherence...Remote workQuality
- ...A healthcare services provider is seeking a Remote Utilization Review Nurse to coordinate clinical resources, ensuring compliance with healthcare... ...health. This contract role offers a chance to manage healthcare quality efficiently while working remotely. #J-18808-Ljbffr...Remote workQualityContract work
- ...Harris Health System is seeking a Utilization Management Review Nurse (UMRN) to assess the necessity and appropriateness of medical services... ...with healthcare teams to resolve denials, and participates in quality improvement activities. Qualified candidates should have a...Remote workQualityFlexible hours
- ...staffing company is seeking a Clinical Review Nurse for Prior Authorization Review. This remote role demands conducting reviews,... .... Candidates need an active RN license and 2–4 years experience... ...are essential for maintaining high-quality care. This 12-month contract...Remote workQualityContract work
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