Remote Medical Review Lead (RN) — Compliance & Quality
$93k - $100kCoventbridge Integrity Systems
- Remote job
CoventBridge Integrity Systems seeks a Medical Review Supervisor (MCP) to lead the MR Department's MCP program. The role oversees medical reviews, coordinates with PI, and ensures ISO/compliance, reporting to the MR Project Manager. Remote from home OFFICE when not local in Grove City, OH. The candidate should be an active RN with 3+ years in management, 4+ years clinical experience, and 4+ years in medical/utilization review or fraud investigation. Salary range $93,000–$100,000. #J-18808-Ljbffr Coventbridge Integrity Systems
- CoventBridge Integrity Systems is seeking a Medical Review Supervisor (MCP) to manage the MCP in the Medical... ...MCP Project Manager. It can be performed remotely if not local to Grove City, OH. The ideal candidate is an RN with supervisory experience, strong communication...Remote jobMedicalLocal area
$35 - $37 per hour
...Lead RN Reviewer Cohere's Service Operations team is responsible for... ...exceeding performance metrics and quality standards established by the... ...style suited for a remote, fast-paced environment... ...opportunity with about 5% travel Medical, dental, vision, life, disability...Remote workQualityMedicalHourly payFlexible hours- ...Health is seeking Clinical Utilization Review Nurses (RN) for a remote position based in Alabama. You will assess the medical necessity and quality of care through prospective,... ...and retrospective reviews to ensure compliance with clinical criteria, policies, and...Remote jobQualityMedical
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Associate Director, Medical Review Lead, MSRM Who we are At Agios, we are fueled by connections... ...medical accuracy, regulatory compliance, and high-quality safety data to support pharmacovigilance... ...role has the ability to be either remote in the US or hybrid in our...Remote workQualityMedicalTemporary workWork from homeFlexible hours3 days per week$29 - $52 per hour
...Program Integrity Clinical Compliance AuditorOptum Insight... ...risk management, quality and revenue growth. Ready... ...performing compliance reviews of medical and administrative... ...schedule.This position is Remote in Massachusetts. You... ...experienceNurse licensure (RN or LPN) with a current...Remote workQualityMedicalHourly payMinimum wageFull timeContract workWork experience placementLive inLocal areaMonday to FridayShift work$35 - $45 per hour
...IntePros is seeking a Remote Utilization Review Nurse serves as a key... ...needs while ensuring compliance with federal, state,... ...outcomes to support quality and cost‑effective care... ...Care Guidelines, and medical necessity... ...professional nursing program (RN, LPN, or LVN). Minimum...Remote workQualityMedicalContract workWeekend work- Machinify is a leading healthcare intelligence company. The Medical Review Nurse II audits home health claims, working remotely with a multi-location team to ensure compliance and high-quality documentation. The role emphasizes strong clinical judgment, coding accuracy,...Remote jobQualityMedicalWork from home
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$40 per hour
...-30 hours week) – Remote Work Environment... ...hour Supports Medical Review Services. The Nurse... ...records to ensure compliance with established guidelines... ...regulations. The RN will work closely with the Team Lead, Physician Peer... ...productivity and quality assurance...Remote workQualityMedicalContract workWork at officeLocal areaImmediate start- ...Type: Hybrid (85% remote, 15% onsite in Burbank... ...for UM Denial Compliance. This role is essential... ...ensuring a high-quality, efficient, and... ...standards for associated medical groups.Key... ...tasks, performance reviews, and disciplinary... ...Nursing Program; RN preferred.2. Minimum...Remote workQualityMedicalPermanent employmentTemporary work
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...the Global Regulatory Lead (GRL), you will be the... ...NDAs, and BLAsDrive high-quality communications with FDA... ...promotional strategy and review press/IR... ...relocation is provided, remote is not available for this... ...benefits; eligibility for medical, dental, vision and prescription...Remote workQualityMedicalLocal areaRelocationFlexible hours- ...Registered Nurse: Review and EvaluationAre... ...Pennsylvania's premier Quality Improvement... ...integrity through compliance management. Here,... ...judgment to analyze medical records, documentation... ...Registered Nurse (RN) licenseStrong... ...with Pennsylvania's leading Quality Improvement...Remote workQualityMedicalWork from home
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...necessary. Assures compliance with all job... ...Expectations: This Lead role encompasses all... ...technicians. Will review and assess the skills... ...initiation of new medication. Oversee packet... ...a positive, high quality work environment.... ...: Unencumbered RN License in the state...QualityMedicalMonday to Friday$26.41 - $51.49 per hour
...clinical member services review assessment processes.... ...verifying that services are medically necessary and align... ...strategy to provide quality and cost-effective member... ...cost-effectiveness and compliance with all state/federal... .... Registered Nurse (RN). License must be active...Remote workQualityMedicalHourly payWork experience placementWork at office$23.76 - $51.49 per hour
...clinical member services review assessment processes.... ...verifying that services are medically necessary and align... ...strategy to provide quality and cost-effective member... ...cost-effectiveness and compliance with all state/federal... ...experience. Registered Nurse (RN). License must be...Remote workQualityMedicalHourly payWork experience placementWork at office- careers-centralhealth seeks a Clinical Quality and Utilization Review Specialist to oversee utilization... ...will coordinate reviews, ensure medical necessity, and lead quality improvement initiatives... ...RCA activities, and ensuring compliance with bylaws, policies, and accreditation...QualityMedical
- ...Blood Bank Lead Medical Lab ScientistPrecisely and accurately... .... Monitors section quality control and preventive... ...test accuracy and compliance with regulatory requirements... ...and reporting for review by physicians or clinical... ...34428 Eligible for Remote Work : On SiteJobLaboratory...Remote workQualityMedicalWork experience placementShift work
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...connect their world. The Compliance Team Lead is an individual... ...control activities, access reviews, training... ...improve the efficiency and quality of compliance work; ability... ...a single platform. Remote-first culture, built... ..., gender expression, medical condition, genetic...Remote workQualityMedical- ...Suicide Mortality Review (SMR) Program, within... ...not limited to medical, behavioral health... ...Data Management and Quality AssuranceEnter... ...secure databases in compliance with ADHS and HIPAA... ...multidisciplinary remote team.... ...Clinical Licensure (RN, LPC, APRN) Bachelor...Remote workQualityMedicalWork at office
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- ...TitleRegistered Nurse (RN) for Critical... ...directly influences quality, safety, and... ...be responsible for reviewing and evaluating critical... ...participant's medical and functional needs... ...integrity and regulatory compliance. This position is... ...to support remote and hybrid work functions...Remote workQualityMedicalWork from home
$91.25k - $120.91k
...qualified healthcare professional for a short-term assignment focused on quality assurance and management. The role includes reviewing cases, providing recommendations, and working closely with Medical Directors. The ideal candidate will have at least three years of...Remote jobQualityMedicalTemporary work- ...meaningful programs like remote patient monitoring... .... With a focus on quality patient care and... ...support therapy compliance. Joining our team... ...program(s) and review benefits and services... ...needs (example - medication refills,... ...Unrestricted Georgia RN License (Compact License...Remote workQualityMedicalFull time
$41.16 - $61.74 per hour
...designed to deliver high-quality, coordinated care.... ...: Comprehensive medical, dental, and... ...Required Licensed RN Required Responsibilities... ...and insures staff compliance with policies and... ...and coordinate remote follow-up visits (... ...and continual review of updates. Clearly...Remote workQualityMedicalFull timeTemporary workWork at officeImmediate startMonday to FridayShift work$144.06k - $205.8k
...diseases with high unmet medical need. Learn more at... ...regulations to ensure compliance.Sets direction for key... ...Manages the preparation and review of registration... ...data presentation and quality scientific data against... ...based in Northbrook, IL. Remote work from anywhere in...Remote workQualityMedicalContract workWork at officeWork from homeWorldwide
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