Clinical Reviewer (RN) (Fully Remote)
Brighterway
- Remote job
Define clinical review standards and gold-standard examples. Flag omissions, causation, and prior-history findings. Requirements: Active RN license and 5+ years clinical experience. Utilization review, case management, or workers' comp experience. Strong written communication and attention to detail. Culture: Small, high-trust team close to founders and customers. Ship weekly and measure on customer outcomes. Brighterway builds AI-native claims software and administration for casualty claims, starting with workers' compensation medical-legal review. The team is small, technical, and close to customers, with everyone shipping and talking directly to users. #J-18808-Ljbffr Brighterway
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...Fully Remote: Clinical Documentation Specialist Facilitate the improvement of clinical documentation... .... Perform concurrent and retrospective reviews of medical records to ensure accurate documentation... .... Qualifications Registered Nurse (RN) with a current license from any state....Remote workLocal areaMonday to Friday$85k - $92k
...Equivalent: ~$41–$44/hr Location: Remote Schedule: Must work AZ hours (typically... ...) Active, unrestricted license: RN Minimum 3+ years clinical experience (med/surg and/or... ...DESIRED) Clinical Quality / Utilization Review / Case Review experience...Remote workHourly payDay shift$38.46 - $43.27 per hour
...Job DescriptionJob DescriptionAs the Clinical Reviewer, you will be responsible for the review and... ...the Jericho, NY office. Ability to work remotely one day per week after introduction period... ...Registered Nurse, required (open to any RN state license).Graduate of a School of...Remote workHourly payFull timeFor contractorsWork at office1 day per week- ...workers' compensation medical-legal review, where our agentic document... ...from them. You will be the clinical conscience of the product: reviewing... .... What we look for Active RN license and 5+ years of... ...opportunity employer. Location: Remote (United States) Employment type...Remote workFull timeFlexible hours
- ...HEDIS RN – Clinical Quality Reviewer Manhattan, NY | 6 Openings | Hybrid | Full-Time HumanEdge Healthcare Staffing is recruiting experienced HEDIS... ...in Manhattan, 100 Church Street. Monday and Friday: Remote. Hours: 8:30 AM–5 PM. Responsibilities Perform medical...Remote workFull timeContract workWork experience placementMonday to Friday
$37.88 - $63.14 per hour
...patients. The mission of the Clinical Documentation Improvement Department... ...medicine degree. This is a fully remote position and available if you... ...position is responsible for reviewing content of the medical record... ...Requires Registered Nurse (RN) license in state of...Remote workWork experience placementLive inMonday to FridayShift work- ...to improve care delivery and patient outcomes.Our talented remote workforce spans the country and plays a vital role in our... ...and professionally. ### Position OverviewWe are seeking an RN to perform Clinical Review work and QIDP reviews work.Team member will serve as the...Remote work
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- ...Health is seeking an experienced Registered Nurse to serve as Clinical Reviewer in a remote, Washington-based role. You will assess medical necessity... ...evidence-based care decisions. The ideal candidate has RN licensure in Washington and at least five years of direct patient...Remote job
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- UnitedHealth Group is seeking a Clinical Grievances Nurse to review retrospective cases for appropriate care and... ...’ immediate needs. The role embraces remote PST hours with an on-site base in... ...requiring CA residency and an active CA RN license. You will assess care against...Remote jobImmediate start
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- Yale University is seeking a Clinical Reviewer within the Yale School of Medicine to support medical necessity reviews, Authorization compliance, and reimbursement optimization. This role evaluates clinical records, payer policies, and treatment plans to ensure services...Remote job
- SCAN Health Insurance is seeking a Clinical Reviewer to provide clinical review of medical claims and post-service appeals, ensuring investigations... ...Director, and participation in cross-functional projects. Remote position with competitive hourly pay and benefits. #J-18808-...Remote jobHourly pay
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- Comagine Health in Washington State is seeking an experienced registered nurse to join our remote clinical reviewer team. In this role you will assess medical necessity, appropriateness, and quality of care for Washington L&I contracts, applying evidence-based guidelines...Remote jobContract work
- Vettedlance is seeking a remote, part-time reviewer with RN or NP licensure to assess clinical documentation and AI-generated triage guidance. You will review, explain, and rate the quality of AI answers and medication/watchlist decisions, supporting safe patient care....Remote jobHourly payWeekly payContract workPart time
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- ...Quality Improvement, Digital Quality Measurement Privacy & Security Enterprise Engagement Officer Compliance Oversight Specialist (Non Clinical) Vice President, Clinical Operations - Behavioral Health UM Medicare Compliance Advisory Project Manager II Manager, Quality...Remote job
- Job Title: Preoperative Clinical Review RN About the Client: A specialized outpatient surgical facility in Fairfax, Virginia, dedicated to providing... ...after competency validation Schedule: Night Shift Setup: Remote Why Join STAFFVIRTUAL? Competitive compensation and...Remote jobNight shift
- ...guidelines, and following internal procedure to determine the viability of the claim for further review in a production environment. Primary Responsibilities: Clinical Case Reviews - 75% Perform clinical review of professional (or facility) claims vs. medical...Remote jobContract workWork at officeLocal areaMonday to Friday
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