Remote Clinical Review Nurse - Concurrent Review
Spectraforce Technologies
- Remote job
Spectraforce Technologies is seeking a Clinical Review Nurse for concurrent review. This remote role supports US-based operations, requiring a nursing credential and at least 1 year of nursing experience. The position emphasizes denial review, NCQA standards, and coordinated communication with agencies and teams. The candidate will draft letters, investigate denials, and help train teams to improve utilization management processes. #J-18808-Ljbffr Spectraforce Technologies
- ...Job Title: Clinical Review Nurse - Concurrent Review Location: Remote -Anywhere in US Shift : Tuesday - Thursday 9:30 am - 6 pm CST / Overtime may be required and Holidays are required Duration : 12 months Position Purpose: Drafts correspondence letters...Remote workLocal areaShift work
$27.02 - $48.55 per hour
About This Role The Clinical Review Nurse performs concurrent reviews to determine members' overall health, evaluate medical necessity, and contribute to... .... Highlights Pay: $27.02 - $48.55 per hour Location: Remote, NY Schedule: Full-time, Monday-Friday, 8:30 AM to 5:00...Remote workHourly payFull timeMonday to FridayFlexible hours$26.5 - $47.59 per hour
Clinical Review Nurse - Concurrent Review Be among the first 25 applicants and get AI-powered advice on this job and more exclusive features. You could... ...including a fresh perspective on workplace flexibility. Remote-US position. Must work Eastern or Central Standard Time....Remote workHourly payWork at officeFlexible hours- 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 jobWork at office
$42 - $45 per hour
...Position Title: Clinical Review Nurse 1 Location: Remote Schedule: Mon- Fri 8-5pm EST Duration: 6 Months (Possibility of Extension and Conversion... ...2 to $45/hr. Responsibilities: ~ Performs concurrent reviews, including determining member's overall...Remote work- Centene is seeking a Clinical Review Nurse to perform concurrent reviews of members to determine overall health, evaluate medical necessity, and contribute... ...of utilization management processes. The position is remote with NY location indicators and offers a full-time...Remote jobFull time
- Kelsey-Seybold Clinic, part of the Optum family, invites you to explore a Concurrent Review Case Manager role. This telephonic position... ...and discharge planning, with remote work allowed nationwide. The... ...RN) or TX LCSW, with 5+ years nursing or 3+ years medical social work...Remote job
- ...CLINICAL REVIEW NURSE - REMOTE ARC Group has multiple positions open for Clinical Review Nurses! These positions are 100% remote. These are direct hire FTE positions with salary, benefits, etc. This is a fantastic opportunity to join a dynamic and well-respected...Remote workPermanent employmentWork at officeLocal area
- ...Clinical Medical Review Nurse We are seeking Licensed Practical Nurses (LPN) or Registered Nurses (RN) to join the Quality team as Clinical Medical... ...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
$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$73k - $82k
...Shield of Vermont is looking for a Clinical Review Registered Nurse to join our Utilization Management team... ...the office with flexibility to work remotely the rest of the week. We are only... ...Conduct clinical reviews for preservice, concurrent, and retrospective authorizations...Remote workWork at officeFlexible hours- Elevance Health is seeking a Clinical Review Nurse II (US) to review and render complex medical determinations ensuring members receive the benefits they are entitled to. The role offers flexibility with virtual work options and occasional in-person training, with some...Remote job
- ...Clinical Medical Review Nurse Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are... ...team with professionalism and a collaborative mindset. Remote work environment with minimal physical demands. Ampcus...Remote work
$75k
...Description • Performs concurrent inpatient utilization review using InterQual criteria... ...care reviews (Skilled Nursing Facility, Inpatient Rehabilitation... ...updates • Engage in clinical collaboration with... ...August Location: 100% remote Equipment: Provided (mini...Remote workFor contractorsWork at officeLocal areaMonday to FridayFlexible hoursWeekend work$60.2k - $107.4k
...opportunities with Kelsey-Seybold Clinic, part of the Optum family of... .... Growing together. The Concurrent Review Case Manager is responsible... ...the flexibility to work remotely * from anywhere within the U... ...Qualifications: Registered Nurse, ADN or master's degree in Social...Remote jobMinimum wageFull timeWork experience placementWork at officeLocal area- Maximus is seeking a Clinical Nurse Consultant to join the Federal Exchange Review Process (FERP) team in a remote capacity. You will manage end-to-end medical reviews, ensure accurate assessments, and coordinate with clinical reviewers to complete cases within timelines...Remote jobMonday to Friday
- ...re looking for US-credentialed clinical professionals to support a... ...use your clinical expertise to review and interpret de-identified electronic... ...US-credentialed Registered Nurse (RN), Nurse Practitioner (NP),... ...working independently in a remote environment. Strong written communication...Remote jobFor contractors
$100 per hour
...reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs... ...JOB SUMMARY: As a Medical Director, Concurrent Review for CorroHealth, you’ll have the unique... ...in Utilization Review. This is a remote position. ESSENTIAL DUTIES AND...Remote workHourly payPart timeWork at officeImmediate startWork from homeMonday to FridayWeekend workAfternoon shift- ...Job Description: Manager of Clinical Utilization Management - Denial... ...CAPosition Type: Hybrid (85% remote, 15% onsite in Northridge, CA... ...daily tasks, performance reviews, and any necessary disciplinary... ...from an accredited Registered Nursing Program; RN preferred.2. Minimum...Remote workPermanent employmentFull timeTemporary workFlexible hours
- ...Providing support for inpatient and outpatient clinical claim review activities, the full-time Remote Registered Nurse Clinical Reviewer will verify coded diagnoses, procedures, and revenue codes to ensure accuracy and compliance with billing guidelines while assessing...Remote workFull time
$65 - $95 per hour
...About the job Remote | Nursing Clinical Review Expert - $65-$95/hour We are sharing a specialised part-time consulting opportunity for nursing professionals experienced in patient care, clinical monitoring, medication administration, clinical documentation, care...Remote workHourly payWeekly payContract workPart timeFor contractorsFlexible hours$69.3k - $78k
...healthcare payment integrity company is seeking a Medical Review Nurse II - Clinical Validation to perform medical claims audits for Government... ...include auditing claims and documenting findings, all in a remote work environment. This role offers a competitive salary range...Remote job- Brighton Health Plan Solutions is seeking an Utilization Management Nurse to perform medical necessity and benefit reviews remotely. The role requires current LPN licensure and expertise in CMS/MCG criteria with experience in inpatient/outpatient reviews. The successful...Remote job
$69.3k - $78k
Overview Medical Review Nurse II - Clinical Validation At Performant, we’re focused on helping our clients achieve their goals by providing technology... ...for Government and Commercial Payers. You will work remotely in a fast paced and dynamic environment and be part of a...Remote workFor contractorsWork at officeWork from homeHome officeShift work$78k - $88k
...Utilization Review Nurse- Remote It takes great medical minds to create powerful solutions that... ...prior authorization, prospective, concurrent, and retrospective reviews for medical... ...appropriateness of services, following clinical criteria, coverage policies, and contract...Remote workFull timeContract workWork at officeWork from homeFlexible hours- ...Doing As a Utilization Management Nurse, you will ensure that home health... ...within compliance. By continuously reviewing and auditing patient treatment files... ...extensive home healthcare. Concurrent review of patient’s clinical information for efficiency Ongoing...Full timeTemporary work
$1,949.74 per month
...Travel Offering Nursing Profession Registered... ...Specialty Utilization Review Job ID 17979666... ...(s) Job Description Remote Utilization Review RN responsible for concurrent reviews, medical necessity determinations...Remote workWeekly payShift work$35 - $45.94 per hour
...We're hiring a Utilization Review Nurse to join our Utilization Review... ...Work Location: This is a remote position, open to candidates... ...for requested services using clinical judgment and Oscar Clinical... ...Previous experience conducting concurrent or inpatient reviews for a...Remote workHourly payFull timeWork from homeHome officeWeekend work$51 per hour
...Utilization Review Specialist (BCBA Licensee) Baltimore, MD (Remote – offsite) Contract To Hire $51/hr (W2) 100% Remote... ...) performs prospective, concurrent, and retrospective reviews to determine... ...services. This role leverages clinical expertise in behavior analysis...Remote workContract workWork at officeWork from home$2,210 per week
...more exclusive features. Nurses - are you looking for... ...Work-life balance. Remote/hybrid setting (once trained... ...will utilize clinical knowledge and communication... ...to a second level reviewer. This individual interfaces... ...precertification and concurrent review within the...Remote workFull timeTemporary workPart timeCasual workWork at officeWork from homeAll shiftsMonday to FridayFlexible hours
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