Clinical Review Nurse - Remote $28.50/hr
$28.5 per hourTEKsystems
Job Title: Clinical Quality Assurance Nurse
Pay: see below
Registered Nurse - $28.50/hr (Non-negotiable)
LPN/LVN- $26.50/hr (non-negotiable)
Regular Schedule after training:
- M-F 11:30am 8pm EST
Training Schedule: 4-6 weeks:
- M-F 9am-5:30pm EST
Position Overview: Responsible for ensuring case reports are of the highest quality and integrity and in full compliance with client contractual agreements, regulatory agency standards and federal and state mandates. This position is required to handle quality assurance questions and provide support to the Quality Assurance Department.
ESSENTIAL JOB FUNCTIONS
Perform quality assurance review of peer review reports, correspondences, addendums or supplemental reviews.
Ensure clear, concise, evidence-based rationales have been provided in support of all recommendations and/or determinations.
Ensure that all client instructions and specifications have been followed and that all questions have been addressed.
Ensure that all client instructions and specifications have been followed and that all questions have been addressed.
Ensure that all client instructions and specifications have been followed and that all questions have been addressed.
Ensure that all client instructions and specifications have been followed and that all questions have been addressed.
Ensure that all client instructions and specifications have been followed and that all questions have been addressed.
Ensure that all client instructions and specifications have been followed and that all questions have been addressed.
Ensure that all client instructions and specifications have been followed and that the peer reviewer has attested to only the facts and that no evidence of reviewer conflict of interest exists.
Ensure the provider credentials and signature are adhered to the final report.
Identify any inconsistencies within the report and contacts the Peer Reviewer to obtain clarification, modification or correction as needed.
Assist in resolution of client complaints and quality assurance issues as needed.
Ensure all federal ERISA and state mandates are adhered to at all times.
Provide insight and direction to management on consultant quality, availability and compliance with all company policies and procedures and client
specifications.
Promote effective and efficient utilization of company resources.
Participate in various educational and or training activities as required.
Perform other duties as assigned.
QUALIFICATIONS
Must have strong knowledge of medical terminology, anatomy and physiology, medications and laboratory values.
Must be a qualified typist with a minimum of 40 W.P.M
Must have a full understanding of HIPAA regulations and compliance.
Must be able to operate a general computer, fax, copier, scanner, and telephone.
Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.
Must demonstrate exceptional communication skills.
Ability to follow instructions and respond to upper managements directions accurately.
Must demonstrate accuracy and thoroughness. Look for ways to improve and promote quality and monitors own work to ensure quality is met.
Must be able to work independently, prioritize work activities and use time efficiently.
Must be able to maintain confidentiality.
Must be able to demonstrate and promote a positive team -oriented environment.
Must be able to stay focused and concentrate under normal or heavy distractions.
Must be able to work well under pressure and or stressful conditions.
Must possess the ability to manage change, delays, or unexpected events appropriately.
Ability to follow all company policies and procedures in effect at time of hire and as they may change or be added from time to time.
Job Type & Location
This is a Contract to Hire position based out of Dallas, TX.
Pay and Benefits
The pay range for this position is $26.50 - $28.50/hr.
Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: Medical, dental & vision Critical Illness, Accident, and Hospital 401(k) Retirement Plan Pre-tax and Roth post-tax contributions available Life Insurance (Voluntary Life & AD&D for the employee and dependents) Short and long-term disability Health Spending Account (HSA) Transportation benefits Employee Assistance Program Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a fully remote position.
Application Deadline
This position is anticipated to close on Oct 5, 2026.
About TEKsystems
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
About TEKsystems and TEKsystems Global Services
Were a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. Were a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. Were strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. Were building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
San Francisco Fair Chance Ordinance
Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.
Massachusetts Lie Detector
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
Use of Artificial Intelligence (AI)
We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.
#J-18808-Ljbffr$28 - $41.5 per hour
Benefits Specialist - $28.00 - $41.50 per hour Join 7Seventy Recruiting... ...more. Base pay range $28.00/hr - $41.50/hr Overview We’re looking... ...periodic follow‑ups to review needs and update benefits Work... ...targets What We Offer 100% remote work - flexibility to work...Remote workHourly payWeekly payFull time$44.7 per hour
...The Utilization Review (UR) RN evaluates the medical... ...works closely with clinical teams case management... ...of an accredited nursing program with a current... ...base rate Weekends $3.50/hour. FTE: .7 (28 hours/week) Benefits... ...covered position Remote Work : No Employment...Remote workHourly payPart timeShift workNight shiftWeekend workAfternoon shift$50 - $90 per hour
...Engineer Type: Part-Time Contractor Compensation: $50–$90/hour Location: Remote About the Opportunity Apply your audio expertise to help train next-generation AI systems by reviewing and annotating robotic video and audio data. No prior AI...Remote workPart timeFor contractorsWork from home$50 - $70 per hour
...Type: Hourly Contract (Part-Time) Compensation: $50–$70/hour Location: Remote About the Opportunity This opportunity is for experienced... ...machine learning, and predictive analytics problems. Review AI-generated approaches involving data preprocessing,...Remote workHourly payWeekly payContract workPart timeFor contractorsWork from home$50 - $100 per hour
.../ Voice Coach Type: Contractor Compensation: $50–$100/hour Location: Remote About the Opportunity We are seeking experienced... ...speech, or evaluation assessments. # Participate in project review and onboarding. # Begin contributing to voice...Remote workFor contractorsWork from homeFlexible hours- ...Candidates MUST HAVE an active RN license from Maryland, Virginia, (or) DC states Role: HEDIS Clinical Review Nurse W2 Contract: 5 Months Location: Primarily remote ~ Requires mandatory on-site training in Meriwether, MD, the week of December 14th and...Remote workContract workWork at officeLocal area
- ...Contract Duration: 5 months Work Location: Primarily Remote (Hybrid focus for candidates residing in MD, DC, or VA). Requires... ...: Work with a leading healthcare organization as a Clinical Medical Review Nurse supporting the annual HEDIS retrospective project. In this...Remote workContract workWork at officeLocal area
$27.02 - $48.55 per hour
...Business Area: Clinical & Care Management Job Type: Full time... ...Purpose: Performs concurrent reviews, including determining member... ...Details: This position is fully remote/work from home. Applicants... ...have a compact/multi-state nursing licensure active and in good...Remote workHourly payFull timePart timeWork at officeWork from homeMonday to FridayFlexible hoursWeekend work- ...A healthcare staffing company is seeking a Clinical Review Nurse for Prior Authorization Review. This remote role demands conducting reviews, collaborating with healthcare teams, and ensuring compliance. Candidates need an active RN license and 2–4 years experience in...Remote workContract work
$28 per hour
...seeking a compassionate registered nurse to provide after-hours hospice... ...and coordinating care with clinical teams. Licensed RNs with... ...comfort using EMR systems will work remotely from home, enjoying paid... ...potential to increase hourly pay to $28 within six months. Strong...Remote workHourly payWork from homeFlexible hours- ...Position Title: Clinical Review Nurse - Prior Authorization Work Location: Remote; nationally sourced within approved U.S. states. Must be available during standard business hours for the assigned team. Assignment Duration: 12 Months possibility of extension or...Remote workWork at officeMonday to Friday
- ...Corporation seeks an LPN/RN with medical necessity review experience to assess prior authorization... ...of care. This full-time role offers remote work from anywhere in the United States... ...timely, cost effective care, document clinical information, and ensure compliance with Medicare...Remote workFull timeLocal area
- ...Position Title: Clinical Review Nurse - Concurrent Review Work Location: Remote (EST preferred but will consider CST) Assignment Duration: 6 months Work Schedule: Eastern 8-5 with expected weekend and holiday coverage based off the team needs. This is usually...Remote workWeekend work
$27.02 - $48.55 per hour
...this role have the flexibility to work remotely from their home anywhere within the state of Missouri. This team performs clinical reviews for medical and behavioral health service... ...Requires Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing and 2 -...Remote workHourly payFull timePart timeWork at officeWork from homeMonday to FridayFlexible hours- ...Job Title: Clinical Review Nurse - Concurrent Review Location:Remote- Nationally but must have Compact license if not in KY (ok with all time zones but must work EST) Duration : 6 months Shift : Mon- Fri 8-5pm EST Job Description: Position Purpose...Remote workShift work
- ...Position Title : Clinical Review Nurse - Concurrent Review Work Location : Remote - Central, Mountain or Pacific preferred Assignment Duration : 6 months (temp to hire) Work Arrangement: Remote Position Summary : Workload review for census management...Remote workTemporary work
- ...Position Title Clinical Review Nurse - Concurrent Review Work Location Remote (EST preferred but will consider CST) Assignment Duration 6 months Work Schedule Eastern 8-5 with expected weekend and holiday coverage based off the team needs. This is usually...Remote workWeekend work
- ...Job TitleLocation: 100% Remote – Any US State Shift: Fri-Sat-Sun... ...correspondence letters based on review outcomes in accordance with... ...opportunities for improvement.Performs clinical review of outcomes including... ...from an accredited school of nursing or A.D. or bachelor's in...Remote workLocal areaShift work
- ...Centene Corporation is seeking a remote Utilization Review Nurse to perform concurrent reviews and validation of appropriate care levels. You will assess inpatient services, discharge planning, and coordination with Medical Affairs across Medicaid and Marketplace programs...Remote work
- ...looking for Medical Record Retrievers/Clinical Record Reviewers to support a need for HEDIS retrospective... ...be efficient. Location: Primarily remote. Candidates are required to attend an... ...or LPN on compact state, OR Certified Nursing Assistant (CNA) or Medical Biller/...Remote work
- ...from an Accredited School of Nursing or Bachelor's degree in Nursing... ...related experience. Clinical knowledge and ability to... ...medical necessity and clinical reviews of authorization requests to... ...collaborative and supportive; Team is REMOTE but team relies heavily on...Remote work
- ...Spectraforce Technologies, Inc. is seeking a Clinical Review Nurse for remote concurrent review responsibilities. The role assesses member health status, medical necessity, and appropriate care levels, contributing to discharge planning within care policies and guidelines...Remote work
$2,300 per month
...The Clinical Review Nurse (RN) supports the organization’s care management function by conducting clinical reviews, ensuring appropriate utilization... ...-effective healthcare outcomes for members. This is a remote role open to candidates residing in Utah, Texas, or Arizona....Remote workPart timeWork at office- ...Clinical Review Nurse - RemoteARC 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 organization...Remote workPermanent employmentWork at officeLocal area
- ...Blueprints Enterprise Architecture EnterpriseTransformation. Position: Clinical Medical Review Nurse HEDIS Retrospective Project Locations: Columbia MD Work Arrangement: Primarily Remote Occasional Provider-Site Visits Position Overview We are seeking experienced...Remote workContract work
- ...About This Role The Clinical Review Nurse-Concurrent Review performs concurrent reviews to determine members' overall health and the appropriateness... ...of utilization management processes. Highlights Location: Remote, OK Schedule: Full Time, Monday-Friday 8am - 5pm, rotational...Remote workFull timeWork at officeMonday to FridayFlexible hoursWeekend work
- ...Spectrumforce Technologies, Inc. is seeking a Clinical Review Nurse - Concurrent Review for a 3-month contract to hire. The role is remote with work location listed as Remote-MS CST, schedule 8 am-5 pm Central time, with occasional weekend rotation. You will perform...Remote workContract work
$40 - $43 per hour
...Job Description Job Description Title: Clinical Review Nurse – Medicaid Denial Letters Location: Fully Remote – Florida Pay: $40.00–$43.00 per hour, based on experience Schedule: 40 hours per week; flexible schedule options: 5 days per week, Friday–Tuesday...Remote workHourly payFlexible hoursShift work$27.02 - $48.55 per hour
...Centene is seeking a Clinical Review Nurse to perform concurrent reviews to assess members' health, determine medical necessity, and contribute... ...strong utilization management knowledge. You will work remotely in North Carolina, with a full-time day shift and pay...Remote workHourly payFull timeDay shift- ...Centene Corporation is seeking a Nurse Reviewer for remote work in the United States. The role involves performing concurrent reviews to determine appropriate level of care and discharge planning, with emphasis on medical necessity and care setting. Requires active...Remote work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Clinical Review Nurse - Remote $28.50/hr. Be the first to apply!
- nurse practitioner urology Dallas, TX
- clinical nurse Dallas, TX
- nurse practitioner Dallas, TX
- outpatient nurse practitioner Dallas, TX
- nurse manager rn - operating room Dallas, TX
- acute care nurse practitioner Dallas, TX
- primary care nurse practitioner Dallas, TX
- orthopedic nurse practitioner Dallas, TX
- cardiology nurse practitioner Dallas, TX
- nurse practitioner per diem Dallas, TX







