Remote RN: Clinical Review & Operations
Medix™
Medix is seeking a fully remote Registered Nurse to perform clinical review and telehealth–style assessments from anywhere in the United States. You will review records, determine next steps, and escalate when needed, while supporting authorization, utilization review, and care coordination processes.
The role requires 3+ years of RN experience, an active license, and strong clinical judgment. Schedule is Monday–Friday, 9:00 AM–6:00 PM ET, with equipment provided and a long-term contract through
#J-18808-Ljbffr$48 - $65 per hour
...Remote Registered Nurse – Clinical Review Fully Remote | $48–$65/hr | Monday–Friday, 9:00 AM–6:00 PM ET Medix... ...Work with clinical and operations teams to resolve issues and improve... ...What we’re looking for ~ Active RN license ~ BSN preferred ~3+ years...Remote workOperationsLong term contractMonday to Friday$2,300 per month
...The Clinical Review Nurse (RN) supports the organization’s care management function by conducting clinical... ...outcomes for members. This is a remote role open to candidates residing in... .../federal regulations governing TPA operations a plus. Strong clinical assessment...Remote workOperationsPart timeWork at office$31 - $35 per hour
...Clinical Review & Correspondence RN The Clinical Review & Correspondence RN plays a critical role in supporting utilization management operations by conducting medical necessity reviews, preparing clear... ...applications This is a 100% remote role, and requires robust...Remote workOperationsFull timeFlexible hoursShift work- ...practice and company procedures. Review and approve patient... ...to have and maintain a valid clinical license, per state requirements... ...approval from the vice president operations or regional president... ...than for designated full-time remote positions, in-office attendance...Remote workOperationsFull timeTemporary workWork at officeLocal areaImmediate startFlexible hours
$29 - $52 per hour
...Clinical Review Clinician Optum is a global organization that delivers care, aided by technology... ...of meeting Optum's core business operations Complete analysis of billing and departmental... ...'s degree ~ Active and unrestricted RN license OR LPN in the state of residence...Remote jobOperationsHourly payMinimum wageFull timeTemporary workWork experience placementLocal area$82.4k - $110k
...Clinical Review RN, Oncology AI Review Position Summary Natera is seeking an experienced... ...Signatera reimbursement and coverage operations. This role will serve as a... ...due to cost of labor considerations. Remote USA $82,400—$110,000 USD OUR OPPORTUNITY...Remote workOperationsFull timeWork at officeImmediate startWorldwide- ...determine the viability of the claim for further review in a production environment. Primary Responsibilities: Clinical Case Reviews - 75% Perform clinical review... ...Examine, assess, and document business operations and procedures to ensure data integrity, data...Remote jobOperationsContract workWork at officeLocal areaMonday to Friday
$40 - $43 per hour
...Description Job Description Title: Clinical Review Nurse – Medicaid Denial Letters Location: Fully Remote – Florida Pay: $40.00–$43.... ...compact Registered Nurse (RN) license. Licensed Practical... ...Medicaid health plan operations. Prior experience working in...Remote workOperationsHourly payFlexible hoursShift work$28.5 per hour
...Job Title: Clinical Quality Assurance Nurse Pay: see below Registered... ...Perform quality assurance review of peer review reports,... ...compliance. Must be able to operate a general computer, fax,... ...Workplace Type This is a fully remote position. Application...Remote workOperationsContract workTemporary work- ...Hone Health in the United States is seeking an RN Clinical Navigator to support doctors and patients, reviewing and triaging issues, and collaborating with the customer service, clinical, and operations teams to ensure the best patient experience in a fast-paced, unstructured...Remote workOperations
- ...Description Job Description: Clinical Supervisor, UM Denial... ...Type: Hybrid (85% remote, 15% onsite in Burbank,... ...tasks, performance reviews, and disciplinary actions... ...Oversee daily departmental operations, including reporting,... ...Nursing Program; RN preferred. 2. Minimum...Remote workOperationsPermanent employmentTemporary work
- ...Hone Health is seeking a dedicated RN Clinical Navigator to join our remote, weekend clinical team. In this... ...will support doctors and patients by reviewing, triaging and elevating issues in... ...with customer service, clinical and operations, delivering timely care in a fast-...Remote workOperationsWeekend work
$65k - $75k
...leader in intelligent operations and transformation, serving... ...• Performs utilization review of cases to determine... .... • Performs clinical reviews according to the... ...Qualifications • RN, LPN/LVN graduate from... ...:00pm CST Location: Remote Compensation Disclosure...Remote workOperationsFull timeWork at officeLocal areaMonday to Friday$63.1k - $94.65k
...steps. Our partner is looking for a Utilization Review RN based in the United States. Join a... ...supporting the financial integrity of hospital operations. In this part-time, remote role, you will apply your clinical expertise to evaluate medical necessity, review...Remote workOperationsTemporary workPart timeWork at officeWork from homeFlexible hoursShift workAfternoon shift$60k - $80k
...Entira Family Clinics provide comprehensive, patient-centered medical... ...Monday-Friday in office. No remote opportunity Clinic assignment... ...members of the care team. Review and follow up on laboratory,... ...patient flow and support clinic operations as needed. Maintain...Remote workOperationsFull timeWork at officeMonday to Friday$63k - $94k
...Remote Utilization Review Registered Nurse (UR RN) Are you an experienced RN looking to transition away from the bedside while still making... ...role, you will act as a vital bridge between clinical care and hospital operations, ensuring patients receive the right level of...Remote workOperationsWork at office10 hours per weekFlexible hoursShift workWeekend workAfternoon shift3 days per week- ...Comagine Health is seeking Clinical Utilization Review Nurses (RN) licensed in Alabama for a remote, full-time role. You will assess medical necessity and quality of healthcare services through prospective, concurrent, and retrospective reviews to support compliant, cost...Remote workFull time
$53 - $59 per hour
## Clinical Documentation SpecialistApplylocations: 160 North Midland... ...Specialists will review the documentation and coding... ...Demands 1. Environmental Demands: Remote with occasional onsite presence... ...necessary for the successful operations of the department including:...Remote workOperationsHome officeShift work- ...Position Summary: The RN Integrated Care Coordinator (UM... ...This role is critical to the operation of our Clinical Team and the overall... ...required to address utilization review cases. Roles and Responsibilities... ...Requirements This is a remote position. Our whole company...Remote workOperationsLive inFlexible hoursWeekday work
$63.1k - $94.65k
...Must have current compact RN license, or be willing... ...populations. Candidates with clinical backgrounds in NICU,... ...: Our Utilization Review team provides coverage seven days a week, operating between 8:00 a.m. and 10... ...Abilities Required: This is a remote role which requires...Remote workOperationsTemporary workWork at officeLocal areaFlexible hoursShift work- ...The Charge Registered Nurse (RN) oversees the daily shift operations of the Virtual Sitting Observation... .... The Charge RN provides clinical leadership and supervision to Remote Patient Safety Observers (... ...regards to patient:PSO ratio • Review observation routines and...Remote workOperationsFull timeImmediate startShift work
$80k - $120k
...Clinical Expert, Care Team Operations (RN) Remote Thesis is building the AI-powered care team platform for infinitely scalable clinical capacity. We radically... .... Support complex clinical operations workflows: Review prior authorizations, appeals, and other clinical-...Remote workOperations- ...UnitedHealth Group is seeking a Preservice Review RN to work remotely in Hawaii. The role involves reviewing non-clinical and clinical documentation to support determinations, with duties across research, coding validation, and care coordination support. Location in Hawaii...Remote work
$42.36 - $61.5 per hour
...Cardiac Cath Lab RN Manager Clinical Operations & Team Leadership Company: HireNow Staffing (Direct Placement... ...six months. Eligibility will be reviewed before submission. Preferred... ...position permits. Roles advertised as remote within the U.S. also require U.S. residency...Remote workOperationsHourly payFull timeRelocationRelocation package- ...and highly organized Clinical Supervisor. This supervisory... ...quality outcomes, and operational excellence of clinical... ...the Registered Nurse (RN) team Support to... ...audits and documentation reviews. Analyze audit findings... ...with telehealth, remote patient monitoring, chronic...Remote workOperationsWork at office
- ...The IRR Clinical Claim Review Nurse at UnitedHealth Group performs claim reviews to verify coding and charges, researching guidelines to determine... ..., MA with a full-time day shift, the position supports remote work anywhere in the U.S. while complying with HIPAA, state...Remote workFull timeDay shift
- ...CVS Health is seeking a Clinical Claims Review Nurse to interpret clinical documentation and apply decision... ...cases. The ideal candidate has RN licensure with 2–3 years of RN... ...hold a bachelor’s degree. This full-time, remote position is based in North Dakota. #J...Remote workFull time
$100k
...Masimo one of Danahers 15 operating companies our work saves... ...everything possible. The Clinical Research Lab RN is responsible for... ...May contribute prepare and review study plans informed consents... ...recognize the benefits of flexible remote working arrangements for...Remote workOperationsHourly payFull timeWork 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 workOperationsContract work
- ...Cardiac Testing & Device Clinic Rn Medical Associates Cardiology... ...safety. Support device clinic operations through pacemaker, ICD, and... ...testing, treatments, and review medical records and confer with... ...evaluations, including in-office and remote monitoring workflows,...Remote workOperationsFull timeTemporary workWork at officeImmediate startMonday to Friday
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote RN: Clinical Review & Operations. Be the first to apply!






