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
- ...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...Remote workMedicalFull timeFlexible hours
- ...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 jobMedicalFlexible hours
- ...Medical Review Clinical Appeals Auditor (RN) In October 2025, Machinify acquired Performant... ...expertise, untangles healthcare data to deliver industry-... ...valuable business insights. Consults with internal... ...to work independently in remote setting with minimum supervision...Remote workMedicalFlexible hours
- ...Description Job Description Fully remote- Must have state of MI unrestricted RN license. You will perform... ...prospective, concurrent and retrospective review of inpatient, outpatient,... ...and ancillary services to ensure medical necessity, appropriate length of stay...Remote workMedicalWork at officeFlexible hours
$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.... ...partner with top-tier hospitals and medical institutions nationwide, helping you...Remote workMedicalHourly payFull timeContract workImmediate startShift work3 days per week- ...Description Job Description We are seeking a Registered Nurse (RN) – Medical Necessity Review (Prior Authorization / Program Exception) to support the... ...in Harrisburg, PA, with a hybrid schedule (three days remote, two days onsite). This position focuses on reviewing...Remote workMedicalLong term contractFull timeContract work
- ...seeking a registered nurse for Clinical Review and QIDP responsibilities, working remotely from any U.S. location. The role requires an active RN license in Alabama, a BA/BS in Nursing,... ...Medicaid criteria to determine medical necessity and managing reviews according...Remote jobMedicalWork from home
- ...regarding admissions, case management, discharge planning and utilization review. Review admissions and service requests within assigned unit for prospective, concurrent and retrospective medical necessity and/or compliance with reimbursement policy criteria. Provide...Remote workMedical
- P3 Health Partners in Henderson, NV is seeking an RN Concurrent Review to ensure compliance with the Medical Management Program. The role may be hybrid or fully remote, with competitive hourly rates based on experience. The successful candidate will have at least two years...Remote jobMedicalHourly pay
- Providence is seeking an RN for a remote Utilization Review role. This per diem position involves conducting prospective, retrospective, and concurrent... .... Responsibilities include daily clinical reviews and assessments of medical records. #J-18808-Ljbffr ProvidenceRemote jobMedicalDaily paid
- COMAGINE HEALTH is seeking Clinical Utilization Review Nurses (RN) for a full-time remote position focused on assessing the medical necessity of healthcare services in Alabama. Candidates must hold an active RN license and possess a BA/BS in nursing, alongside a minimum...Remote jobMedicalFull time
$84.06k - $118.67k
...seeks a Licensed Registered Nurse for a remote position in Utilization Management. The... ...admissions and discharge planning, conducting reviews for medical necessity, and assisting with coding and claims issues. Candidates must hold an RN license from the Texas Board of Nursing...Remote jobMedical- ...Healthcare, Inc. is hiring a full-time Licensed Medical Review Nurse to conduct reviews of medical documentation while working remotely. This role involves managing appeals and... ..., including utilization review, and a valid RN license in Florida or Kentucky. Strong analytical...Remote jobMedicalFull time
- Providence Health & Services is hiring a Utilization Review RN for a remote position focused on administering medical management programs, including prior authorization and review processes. Candidates must have a strong clinical nursing background with 5 years of experience...Remote jobMedical
$28.37 - $36 per hour
Acentra Health, LLC is seeking a Clinical Reviewer - RN - PRN (Remote U.S.) to interpret patient records, ensuring medical necessity and appropriateness of care. Ideal candidates will possess an RN license and relevant clinical experience. This position offers flexible...Remote jobMedicalReliefFlexible hours- CorVel Corporation is looking for a Data Verification Specialist responsible for a range of clerical functions involving medical bill processing. This remote position requires validating data, applying customer-specific rules, and communicating effectively with supervisors...Remote jobMedicalWork at office
- UnitedHealth Group is seeking a Clinical Review Clinician in Plymouth, Minnesota. This role... ...should have an Associate's degree, an active RN or LPN license, and at least 2 years of... ...experience. Benefits include paid time off, medical plans, and a comprehensive benefits...Remote jobMedical
- ...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 Alabama... ...include applying Medicaid criteria to determine medical necessity, completing reviews within established...Remote jobMedical
- ...Healthcare, Inc. is seeking a full-time Michigan Licensed Medical Review Nurse to manage the review of documentation in a remote capacity. This role involves ensuring medical... ...nursing experience and possess an active RN license in Michigan. Knowledge of coding and health...Remote jobMedicalFull time
- A 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...Remote jobMedicalFlexible hours
- National Government Services is seeking a Clinical Review Nurse I for Medicare Part A, primarily... ...they meet members' benefits based on medical policy. Qualifications include an Associate's degree in nursing, an active RN license, and at least one year of clinical experience...Remote jobMedical
- 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 and...Remote jobMedicalFull time
$49.34 - $76.59 per hour
...leading healthcare organization is seeking a Utilization Review RN for a fully remote role in Oregon. Candidates must hold an Oregon Registered... ...particularly in collaboration with physicians. This position manages medical management programs to optimize patient care. Competitive...Remote jobMedical$28.94 - $51.63 per hour
...Association Inc is seeking a Clinical Appeals RN to manage appeals and grievances... ...proficiency with Microsoft Office. You will review medical records, assess clinical eligibility for... ...with all regulations while working remotely from anywhere in the U.S. Attractive benefits...Remote jobMedicalHourly payWork at office$75k
...looking for a Registered Nurse (RN) to perform concurrent inpatient utilization reviews. The role requires a BSN and current... ...vision benefits. The position is remote with a standard Monday-Friday... ...emphasizes teamwork and compliance with medical standards. #J-18808-Ljbffr...Remote jobMedicalMonday to Friday- ...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 jobMedical
- ...Abstractor The Suicide Mortality Review (SMR) Program, within the... .... The SMR Program integrates data from medical, behavioral health, and... ...communication within a multidisciplinary remote team. Qualifications... ...Nurse Clinical Licensure (RN, LPC, APRN) Bachelor's Degree...Remote workMedicalWork at office
$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 closely with Medical Directors. The ideal candidate will have at least three years of relevant experience in...Remote jobMedicalTemporary work- Inland Empire Health Plans seeks a Provider Quality Review Nurse, RN to ensure high-quality care delivery through case review and quality assurance... ...include investigating PQI cases and working closely with the Medical Director on resolutions. Join IEHP for an impactful career in...Remote jobMedical
- ...Territorial Epidemiologists is seeking a Clinical Review Supervisor to provide operational... ...utilization review activities. This fully remote position requires an RN license and relevant experience in patient care and medical management. The role focuses on quality oversight...Remote jobMedical
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