Remote Clinical Quality Reviewer: Prior Authorization
CorroHealth Inc
CorroHealth Inc. seeks a remote Clinical Reviewer to support the WISeR Prior Authorization Program across the US. You will perform clinical reviews, validate documentation, and support physician determinations in CMS-aligned workflows.
The role emphasizes accuracy, regulatory compliance, and collaboration with physicians, nurses, quality teams, and technology partners in a 24/7 review environment.
#J-18808-Ljbffr$28.37 - $39.19 per hour
...technology, services, and clinical expertise. Our mission... ...for a Clinical Reviewer - Arkansas Behavioral Health License (Remote within Arkansas) to join... ...requirements. Completes prior authorization, continued stay, and... ...and retrospective quality reviews for Inpatient...Remote workQualityContract workWork at officeLocal areaMonday to FridayFlexible hours- ...our scalable solutions and clinical expertise help solve... ...Member.This position is REMOTE within US Only - Equipment providedThe Clinical Reviewer supports the WISeR Prior Authorization Program by performing comprehensive... ...with physicians, nurses, quality teams, customer service,...Remote workQualityWork at officeImmediate startFlexible hoursAfternoon shift
$110k - $140k
...Clinical Quality Reviewer - BCBA About Onos Health Onos Health's mission is simple but ambitious... ...management, care review, or prior authorization review for a payer or managed care organization... ...office (Financial District), remote-first culture ~ Unlimited vacation...Remote workQualityWork at officeHome officeFlexible hours2 days per week3 days per week- ...The Clinical Pharmacy Reviewer (Pharmacist) evaluates complex prior authorization requests, appeals, and medication coverage determinations... ...Street's commitment to high-quality healthcare delivery and... ...Dane Street? Collaborative remote culture Professional growth...Remote workQualityContract workLocal areaWork from home
- ...Remote USA, TN, Chattanooga, Remote Full time... ...4 We are hiring a Clinical Assistant at BCBST!... ...environment where quality, accuracy, and teamwork... ...goals. Perform projects, review and handle reports as... ...of the notification /prior authorization process. This job...Remote workQualityFull timeWork at officeWork from homeRelocation packageRotating shiftAfternoon shiftEarly shift
$75 per hour
...scenarios and refine tasks based on quality reviews and stakeholder feedback. Adhere to project... ...Utilization review, Case management, Prior authorization, Medical terminology, Health care,... .... Able to work independently in a remote setting while managing priorities, deadlines...Remote workQualityContract workTemporary work$22 - $23 per hour
...Remote Clinical Pharmacy Clerk Atlanta, Georgia, United States $ 22.00 - 23.00 (US Dollar... ...members representatives for pharmacy prior authorizations, exceptions, and appeals Enter... ...Assist with departmental audits and quality improvement activities Global Channel...Remote jobQualityWork at office$18 - $25.8 per hour
...for two passionate onsite Clinical Assistants to join our team... ...focus on delivering high-quality mental healthcare . Why... ...scheduling with in-office, remote, or hybrid options, depending... ...Assist with medication reviews, prior authorization and referral processes and...Remote workQualityHourly payWork at officeLocal areaFlexible hoursShift work- ...offering hybrid or remote work arrangements for... ...is responsible for reviewing and coding clinical and outpatient medical... .... Compliance & Quality: Respond to coding and... ...Support: Obtain authorizations for procedures and surgical... ...counseling prior to services being rendered...Remote workQualityFull timeWork at officeMonday to Friday
- ...utilization management activities including prior authorization review, concurrent review, retrospective... ...and regulatory guidelines. Evaluates clinical information to determine medical... ...and interdisciplinary teams to promote quality outcomes, appropriate utilization of...Quality
$30 - $50 per hour
...Clinical Data QA Reviewer $30-50/hr Remote Freelance STEM About the Role We're looking for detail-oriented... ...electronic health record (EHR) data for quality assurance. Your expertise directly... ...health information management Prior work in data annotation, QA, or...Remote workQualityHourly payOngoing contractContract workFreelanceFlexible hours- ...community? Do you enjoy using your clinical expertise to evaluate needs,... ...? In this role, you will review clinical documentation to... ...expertise to stakeholders; support quality activities and audits; and... ...on this team. This is a remote position based in Oregon and...Remote workQualityFull timeContract workWork from home
$60.2k - $107.4k
...communities and removing barriers to quality care. The work you do here... ...is to provide a front line clinical resource to provide... ...the flexibility to work remotely from anywhere within the U.... ...status on previously submitted prior authorizations or pre-determination...Remote jobQualityMinimum wageFull timeWork experience placementLocal areaMonday to Friday- ...looking for a licensed Nurse Practitioner to serve as a Clinical Chart Reviewer. This remote role requires conducting patient evaluations and reviewing... ...will develop individualized care plans and engage in quality assurance efforts to improve patient outcomes. A minimum...Remote workQuality
- A healthcare solutions provider is seeking a Remote Pharmacist to conduct VA quality reviews, focusing on clinical assessments without direct patient interaction. Candidates must have a Doctor of Pharmacy (PharmD) and an active pharmacist license in the U.S. Responsibilities...Remote workQualityFlexible hours
$40 - $44 per hour
...Job title: Clinical Quality Reviewer Location: Remote Duration: 6 months (Contract To hire) Shift : Standard hours | Mon-Fri | 40 Hours Week Pay Range: $40.00 - $44.00 Per hr on w2. Job Summary Ensures compliance with the contract, and program...Remote workQualityContract workInterim roleWork at officeShift work- ...TEEMA is seeking a Registered Nurse for a remote role with Arizona hours (1st shift). You will review medical records for quality, safety, and utilization issues, identify PQIs... ...an active RN license, have 3+ years of clinical experience in med/surg or behavioral health...Remote workQualityDay shift
$85k - $92k
...Job Title: CLINICAL QUALITY REVIEWER (RN or LCSW) Job ID: 90896 Location: USA- Remote in approved states Overview: We are partnering with a leading organization supporting a large-scale federal healthcare program to identify a Clinical Quality Reviewer. This role...Remote workQualityHourly payWork at officeHome office- ...A healthcare consulting firm is seeking a Licensed Social Worker (Non-Mental Health) to perform remote quality reviews for the U.S. Department of Veterans Affairs. This position requires an MSW and independent state licensure, with 3+ years of related experience. Responsibilities...Remote workQualityFlexible hours
$50 - $52 per hour
...Claims Clinical Documentation Reviewer Schedule: 5-10 hours per week. Resource can... ...weekends if they prefer. Remote position. Equipment is provided... .... Knowledge Service Authorization concepts, principles, and... ...and implementation, prior authorization functions and...Remote workPart timeWork at officeLong distance10 hours per week$85k - $92k
...Equivalent: ~$41–$44/hr Location: Remote Schedule: Must work AZ hours (typically... ...license: RN Minimum 3+ years clinical experience (med/surg and/or... ...Qualifications (highly Desired) Clinical Quality / Utilization Review / Case Review experience...Remote workQualityHourly payDay shift- ...organization that has engaged in health care quality consulting and quality improvement... ...and patient outcomes. Our talented remote workforce spans the country and plays a... ...Overview We are seeking an RN to perform Clinical Review work and QIDP reviews work. Team member...Remote workQualityContract work
$57 per hour
...ProPivotal Staffing is seeking a Clinical Pharmacist Reviewer to work from home in Massachusetts. This role supports clinical pharmacy services and involves optimizing treatments with healthcare teams. Candidates should have 1-2 years of experience and an active Massachusetts...Remote workHourly payWork from homeFlexible hours- ...Actalent is seeking a Clinical Prior Authorization Reviewer to join our remote team supporting Dallas, TX operations. This contract role focuses on evaluating prior authorization requests for medical necessity and appropriate level of care using InterQual and Milliman...Remote workContract work
- ...Senior Surgical Clinical Reviewer Be a part of a world-class academic healthcare system at UChicago... .... This position will be primarily a remote work from home opportunity. The... ...College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP). This is...Remote workQualityFull timeWork from homeShift work
- ...Clinical Insurance Reviewer The US Oncology Network is looking for a Clinical... ...Oncology. This full-time remote position will support the... ...This role handles obtaining authorizations for diagnostic imaging across... ...Oncology delivers high-quality, evidence-based care to patients...Remote workQualityFull timeWork experience placementWork at officeMonday to FridayShift work
- ...are seeking experienced physicians to review inpatient clinical documentation and assess its clinical... ...experience and a commitment to clinical quality and documentation standards. Key... ...Ability to work independently and maintain consistent quality in a remote environment....Remote workQualityContract work
$77k - $80k
...Quality Reviewer BAYADA Home Health Care has an immediate opening for a Full Time, Quality... ...Reviewer with OASIS certification to work remotely. RN's with certifications will be... ...and OASIS assessments. This role ensures clinical accuracy, regulatory compliance with Medicare...Remote workQualityFull timeWork at officeLocal areaImmediate start- ...Acentra Health is seeking a Clinical Reviewer to join our growing team. You will apply clinical... ...accuracy and compliance. The position is remote national scope, with on‑call weekends,... ...cross‑functional teams to support high‑quality health solutions for public sector...Remote workQualityContract workWeekend workAfternoon shift
- ...through technology, services, and clinical expertise. Our mission is to... ...to increase efficiency, quality, and impact in their roles.... ...Health is looking for a Clinical Reviewer to join our growing team.... ...requirements. ~*Position is remote* ~*Required Work Hours: On‑call...Remote workQualityContract workReliefWeekend workAfternoon shift
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