Remote RN - Medical Review & Data Insights Specialist
Ampcus Inc
- Remote job
A technology and business consulting firm is seeking a Clinical Medical Review Nurse to analyze health data and provide insights for internal stakeholders. The ideal candidate has a Registered Nurse license, along with four years of clinical experience and two years of healthcare data analysis. Strong proficiency in Excel and excellent communication skills are essential. This role primarily supports internal initiatives and offers a remote work environment with a collaborative atmosphere. #J-18808-Ljbffr Ampcus Inc
$86k - $138k
...Peraton is seeking an experienced Data Insights & Visualization Specialist remote role supporting TDAC at APG, MD.... ...employees a variety of benefits including medical, dental, vision, life, health... ...role and the Company. During the review of your application, you may be required...Remote workMedicalFull timeContract workTemporary workShift work- ...Title Registered Nurse (RN) for Critical Incident... ...be responsible for reviewing and evaluating critical... ...with each participant's medical and functional needs. You... ...service agencies. Your insights will help shape care... ...technology to support remote and hybrid work functions...Remote workMedicalWork from home
- ...staffing and recruiting firm is seeking a HEDIS Nurse (RN or LPN) for a remote position which allows for a flexible schedule. This high... ...and be proficient in Excel, with solid skills in medical records review. Join a motivated team dedicated to quality outcomes and...Remote workMedicalFlexible hours
- ...comprehensive benefits package that includes medical, dental, vision, life, and disability,... ...Great Waters Federal is seeking a Journeyman Data & Insights Specialist based in the National Capital Region or available for remote work. The selected candidate will be responsible...Remote jobMedicalFull timeFlexible hours
$63.1k - $94.65k
...have current compact RN license, or be... ...Virtual Utilization Review Specialist with at least 1... ...third party payers Medical Necessity... ...Accurately records data for statistical entry... ...Required: ~ This is a remote role which... ...Healthcare Business Insights (HBI) Revenue Cycle...Remote workMedicalFull timeTemporary workWork at officeLocal areaMonday to FridayShift work$81.95k - $110.24k
...The Lead Utilization Review RN is a key contributor to... ...quality and completeness of medical record documentation.... .... Accurately records data for statistical entry and... ...required #LI-LS1 #LI-REMOTE Join an award-... ...Clarivate Healthcare Business Insights (HBI) Revenue Cycle...Remote workMedicalFull timeWork at officeLocal area- ...Hygienist Clinical Content Reviewer. This remote North America role supports... ...relevance, collaborating with data teams to ensure high-quality... ...care. You will assess emerging medical technologies, contribute to... ..., and provide expert insights while balancing flexibility...Remote jobMedicalPart timeRelief
$47.03 - $63.48 per hour
...in healthcare. The RN, Senior Utilization Review Quality will play an... ...Mentors other UR Quality Specialist and UR team members... ...regarding medical necessity, clinical... ...experiences This is a remote position; however, candidates... ...Healthcare Business Insights (HBI) Revenue Cycle...Remote workMedicalTemporary workWork at officeLocal area- ...Sedgwick is seeking a Telecommuter RN for Utilization Review in the United States. The role requires... ...Certification is a plus. The position offers remote work with a comprehensive benefits... ...reviewing treatment plans, obtaining medical records, and applying criteria to...Remote workMedical
- ...A leading healthcare organization is seeking a full-time remote RN responsible for validating medical necessity in the insurance industry. This role involves performing medical reviews on claims and requires a nursing license, alongside experience in claims processing...Remote workMedicalFull time
$39.4 - $53 per hour
...Overview The Lead Utilization Review RN is a key contributor to... ...and completeness of medical record documentation.... .... Accurately records data for statistical entry and... ...Healthcare Business Insights (HBI) Revenue Cycle Awards... ...Top Workplace for Remote Work 2024 Great Place to...Remote workMedicalWork at officeLocal area$30 - $38 per hour
...A healthcare organization is seeking a part-time Utilization Review Nurse RN to conduct assessments and reviews for medical necessity of treatment requests. This role involves working 28 hours per week with responsibilities such as providing reviews for pre-certification...Remote workMedicalHourly payPart time- ...Registered Nurse for Utilization Management in a remote-capable role. This position focuses on reviewing admissions and service requests for medical necessity, coordinating care, and... ...the organization. The role requires Texas RN licensure and a nursing diploma, with...Remote workMedical
- ...Cincinnati Children e s Hospital Medical Center is seeking a Remote Utilization Review professional to perform admission and continued stay reviews using InterQual, ensuring medical necessity and appropriate level of care.The role collaborates with Admitting, Financial...Remote workMedical
$1,949.74 per month
...Specialty Utilization Review Job ID 17979666... ...Title Utilization Review RN Weekly Pay $1949.74... ...) Job Description Remote Utilization Review RN responsible for concurrent reviews, medical necessity determinations, prior...Remote workMedicalWeekly payShift work$85k - $92k
...$41–$44/hr Location: Remote Schedule: Must work AZ... ...license: RN Minimum 3+ years clinical... ...Clinical Quality / Utilization Review / Case Review experience... ...criteria tools Data analysis / reporting exposure... ...Do) Review medical records for quality, safety...Remote workMedicalHourly payDay shift- Elevance Health is seeking an experienced nurse to review complex cases for medical necessity, applying clinical guidelines and nursing judgment. The role involves collaboration with physicians, case managers, and Medical Directors to optimize member outcomes. Ideal candidates...Remote jobMedical
- Leave Your Mark is seeking a Registered Nurse for Utilization Review to support a Michigan health plan client from a home-based setting... ..., concurrent, and retrospective reviews to determine medical necessity, level of care, and length of stay for various services...Remote jobMedicalWork from home
- ...Broadway Ventures is seeking a dedicated Registered Nurse (RN) to join our Medical Review team in a remote role. You will conduct pre- and post-payment medical reviews to ensure criteria compliance, assess medical necessity and reimbursement eligibility, and document decisions...Remote workMedical
- ...seeking a highly motivated Utilization Review RN to join our team. The role involves prospective... ...and retrospective reviews to ensure medical necessity and appropriate level of care... ...settings. The position supports remote work in the US, requires an unrestricted...Remote jobMedicalContract work
- Molina Healthcare, Inc. is seeking a remote Care Review Clinician to support the OH Medicaid population... ...services. The role requires an active RN license in OH or a compact license and... ...experience. The position involves evaluating medical necessity, coordinating with medical...Remote jobMedical
- ...Healthcare Alliance is seeking a Utilization Management Clinical Review nurse to assess medical necessity and manage prior authorizations for Behavioral... ...for Medical Director review. The role requires an active RN license, US citizenship, and the ability to obtain DoD...Remote jobMedical
- ...experienced Registered Nurse to join our Washington State remote clinical review team. You will assess medical necessity and care quality, using evidence-based... ...support decision-making. The role requires an active WA RN license, at least five years of bedside nursing, and...Remote jobMedical
- ...is seeking an experienced Utilization Review RN Specialist for a remote-capable role serving the greater... ...area. The position focuses on reviewing medical necessity and coordinating reviews for... ...ensuring appropriate level of care and data reporting accuracy. Responsibilities...Remote jobMedical
- ...Technologies, Inc. is seeking a Clinical Review Nurse - Prior Authorization... ...month assignment. The role is remote (PST/CST) with scheduling... ...will review PA requests for medical necessity, assess complex... ...aligning with compliance standards. RN licensure is required, with...Remote jobMedicalShift work
$85k - $92k
...identify a Clinical Quality Reviewer. This role focuses on... ...will be doing:Review medical records to identify... ...as a Registered Nurse (RN) or Licensed Clinical Social... ...Exposure to healthcare data analysis or reporting... ...environmentOther Information:Remote or onsite depending on...Remote workMedicalHourly payWork at officeHome office- ...DescriptionLocation: Fully remote. Candidates must be able... ...an experienced Concurrent Review Registered Nurse (RN) to join its Utilization Management... ..., prior authorizations, medical necessity reviews,... ...physicians, hospital staff, specialists, and internal care management...Remote workMedicalWork at officeImmediate start
- ...specific to the LTSS department. RN will be responsible for... ...appropriateness/efficiency of the use of Medical Services for Long-Term Support... ...authorization and concurrent review. Provides monthly telephonic... ...Info: *possible remote opportunity after training if...Remote workMedicalContract workMonday to FridayFlexible hours
- Comagine Health is seeking an experienced Registered Nurse for a remote Clinical Reviewer role supporting a Washington L&I contract. The position emphasizes evaluating medical necessity, quality, and appropriateness of care using established criteria and guidelines. You...Remote jobMedicalContract workWork from home
- ...registered nurse to perform concurrent inpatient utilization review using InterQual criteria, supporting medical necessity decisions across hospital settings. You... ...skills, and the ability to operate independently in a remote, US-based #J-18808-Ljbffr WNS Global ServicesRemote jobMedical
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