Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Clinical Reviewer (RN) (Fully Remote)

Brighterway

New York, NY
  • 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

Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Clinical Reviewer (RN) (Fully Remote) in New York, NY vacancy
  • Centene Corporation is seeking a fully remote RN appeals reviewer to support processing of medical necessity reviews for appeals. You will research medical records and apply NCQA standards to determine appropriate resolutions. The role prefers an active RN license (New... 
    Remote job

    Centene Corp.

    Salem, OR
    3 days ago
  • Centene Management Company is seeking a licensed RN to perform clinical reviews for appeals, examining medical records and data to determine medical necessity in line with NCQA standards. This is a fully remote role, with a preference for an active, unrestricted New York... 
    Remote job

    Centene Management Company

    New York, NY
    17 hours ago
  • $70k - $120k

     ...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 work
    Local area
    Monday to Friday

    Actalent

    Leesburg, VA
    2 days ago
  • $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 work
    Hourly pay
    Day shift

    TEEMA

    United States
    5 days ago
  • $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 work
    Hourly pay
    Full time
    For contractors
    Work at office
    1 day per week

    ISLAND PEER REVIEW ORGANIZATION INC

    Jericho, NY
    3 days ago
  •  ...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 work
    Full time
    Flexible hours

    Brighterway, Inc.

    New York, NY
    1 day ago
  •  ...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 work
    Full time
    Contract work
    Work experience placement
    Monday to Friday

    HumanEdge

    Manhattan, NY
    7 days ago
  • $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 work
    Work experience placement
    Live in
    Monday to Friday
    Shift work

    Banner Health Corporate

    Phoenix, AZ
    4 days ago
  •  ...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

    Comagine Health

    Albany, NY
    1 day ago
  • Comagine Health is seeking an experienced Registered Nurse for a remote Clinical Reviewer role supporting a Washington L&I contract. The position emphasizes evaluating medical necessity, quality, and appropriateness of care using established criteria and guidelines. You... 
    Remote job
    Contract work
    Work from home

    Comagine Health

    Las Vegas, NV
    2 days ago
  • Comagine Health, a national nonprofit healthcare consulting organization, seeks a Clinical Reviewer (RN) to support the Washington Labor & Industries contract. This remote role leverages nursing expertise to evaluate medical necessity and quality of care, collaborating... 
    Remote job
    Contract work
    Work from home

    California Nursing Students Association Incorporated

    Seattle, WA
    2 days ago
  • Comagine Health is seeking a Clinical Reviewer (RN) to support the Washington Labor & Industries contract in a remote capacity. The role leverages nursing experience to assess medical necessity and care quality from home. You will collaborate with physicians and internal... 
    Remote job
    Contract work

    Anacalifornia

    Seattle, WA
    2 days ago
  • Lynn Rodens is seeking a skilled Clinical Reviewer/Nurse for a remote role aligned with AZ hours. The position requires active RN license, U.S. citizenship, 3+ years in med/surg and/or behavioral health, and eligibility for DoD background clearance. Ideal candidates have... 
    Remote job

    Lynn Rodens

    Phoenix, AZ
    3 days ago
  •  ...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

    Comagine Health

    Seattle, WA
    3 days ago
  • Comagine Health is seeking a Clinical Reviewer (RN) remotely to support Washington state contracts. The role evaluates medical necessity and quality of care, collaborating with physician consultants and internal teams to ensure compliant, evidence-based decisions. The ideal... 
    Remote job

    Lonestar State College

    Anchorage, AK
    2 days ago
  • 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 job
    Immediate start

    UnitedHealth Group

    Phoenix, AZ
    3 days ago
  • Comagine Health is seeking a Clinical Reviewer (RN) to evaluate medical necessity, quality and appropriateness of services under the WA L&I contract. This remote role supports case reviews across inpatient, outpatient, and complex imaging by applying evidence-based criteria... 
    Remote job
    Contract work

    Comagine Health

    Portland, OR
    2 days ago
  • Comagine Health is seeking an experienced Registered Nurse to serve as a Clinical Reviewer for the Washington Labor & Industries (L&I) contract. This remote role utilizes nursing expertise to evaluate medical necessity and quality of care, supporting evidence-based decision... 
    Remote job
    Contract work
    Home office

    Comagine Health

    Sacramento, CA
    2 days ago
  • SCAN Health Plan is seeking a qualified Nurse Reviewer to perform clinical review of medical claims and post-service appeals. The role involves applying...  .... The ideal candidate holds an active California RN license, an Associate’s degree or higher, and 3-5 years of... 
    Remote job

    SCAN Health Plan

    New York, NY
    5 days ago
  • 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

    Yale Corporation

    New Haven, CT
    17 hours ago
  • 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 job
    Hourly pay

    SCAN Health Insurance

    Salem, OR
    2 days ago
  • Hippocratic AI is seeking Registered Nurses with 5+ years of clinical experience for a remote data annotation contract role. You will review AI agent conversations across primary care and related areas and provide safety-focused feedback. The position is 1099 contract with... 
    Remote job
    Contract work
    Flexible hours

    Hippocratic AI Inc.

    New York, NY
    5 days ago
  • Comagine Health, a national nonprofit healthcare consulting organization, is seeking a Clinical Reviewer (Registered Nurse) to support Washington Labor & Industries contract. This remote role focuses on evaluating medical necessity, appropriateness, and quality of care... 
    Remote job
    Contract work

    Comagine Health

    Albany, NY
    2 days ago
  • Comagine Health is seeking an experienced Registered Nurse to transition into a remote Clinical Reviewer role supporting the Washington L&I contract. The role focuses on evaluating medical necessity, appropriateness, and quality of healthcare services to promote evidence... 
    Remote job
    Contract work

    COMAGINE HEALTH

    Beaverton, OR
    2 days ago
  • 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 job
    Contract work

    Comagine Health

    Seattle, WA
    2 days ago
  • 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 job
    Hourly pay
    Weekly pay
    Contract work
    Part time

    Vettedlance

    New York, NY
    17 hours ago
  • Comagine Health is seeking a licensed RN for a remote Clinical Reviewer role supporting the Washington L&I contract. The position focuses on evaluating medical necessity, clinical appropriateness, and quality of healthcare services through prospective, concurrent, and retrospective... 
    Remote job
    Contract work

    Comagine Health

    Jackson, MS
    2 days ago
  •  ...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

    Centene Corp.

    Austin, TX
    5 days ago
  • 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 job
    Night shift

    STAFFVIRTUAL, Inc.

    New York, NY
    2 days ago
  •  ...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 job
    Contract work
    Work at office
    Local area
    Monday to Friday

    UnitedHealthcare At Home

    Puerto Rico
    2 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Clinical Reviewer (RN) (Fully Remote). Be the first to apply!