Clinical Review Nurse
Virtual Vocations Inc
To support the Home Health Services Team, the full-time Clinical Review Nurse will manage clinical staff oversight, ensure accurate documentation and coding, and implement educational initiatives, all while working remotely during day shifts. Key responsibilities Direct clinical staff through oversight of coding, care plans, and patient care provision Conduct initial medical record reviews within 24 hours of the SOC assessment for OASIS submission accuracy Develop and implement education initiatives to enhance documentation quality based on identified trends Required qualifications Bachelor's degree in Physical Therapy, Occupational Therapy, or a related area required Associate Degree in Nursing required Two years of clinical experience Experience in the Home Health environment preferred Current license (RN/PT/OT) required
$17.37 - $28.95 per hour
...Clinical Chart Review Explore opportunities with Holston Medical Group, part of the Optum family of businesses. Holston Medical Group combines... ...needed based on the algorithm/process as predetermined by nursing management and provider Manage variables from the...SuggestedWork at office- ...Assistance Program ~ Rewards and Recognition Programs ~ Paid Time Off and Paid Sick Leave Summary Statement The Clinical Review Nurse is responsible for reviewing and making medical determinations as to the validity of health claims and levels of payment in...SuggestedPermanent employmentTemporary workWork at officeLocal areaImmediate startRemote work
- ...Clinical Reviewer – Registered Nurse (RN) Comagine Health | Washington State | Remote / Work From Home Department: Care Management Contract: Washington Labor & Industries (L&I) Location: Washington State – Remote Employment Type: Full-Time This is an...SuggestedFull timeContract workLocal areaRemote workWork from homeHome office
- ...CLINICAL REVIEW NURSE - REMOTE ARC 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...SuggestedPermanent employmentWork at officeLocal areaRemote work
$33.5 - $45 per hour
...-2 years of inpatient and SNF Concurrent review and discharge planning experience. To provide... ..., and BH. The case manager is a licensed nurse (RN or LVN). A care manager can be a... ...and contracts. * Review and process clinical information in accordance with regulatory...SuggestedHourly pay- ...Responsibilities: Perform medical necessity reviews of inpatient admissions and continued stays. Apply clinical criteria and guidelines such as InterQual, internal... .... Make authorization determinations within nursing scope. Identify discharge planning needs and...Hourly payRemote workFlexible hoursShift workWeekend work
- ...Clinical Nurse Reviewer As one of the fastest growing Independent Physician Associations in Southern California, our organization offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people...Work experience placementFlexible hours
- ...Clinical Review Nurse I Virtual : This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures...Full timeTemporary workWork at officeLocal area1 day per week
- ...Position Title: Clinical Review Nurse - Concurrent Review Work Location: Remote-MS CST Assignment Duration: 3 Months Contract to Hire Work Schedule: 8 am-5 pm (Central). OT is voluntary; weekend rotation once every 2 months Work Arrangement: Remote Position...Contract workRemote workFlexible hoursWeekend work
$27.02 - $48.55 per hour
...Business Area: Clinical & Care Management Job Type: Full time Position Purpose: Performs concurrent reviews, including determining member's overall health, reviewing the type... ...Graduate from an Accredited School of Nursing or Bachelor’s degree in Nursing and 2 –...Hourly payFull timePart timeWork at officeRemote workMonday to FridayFlexible hours- ...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:...Temporary workRemote 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
$37 - $39 per hour
...Immediate need for a talented Clinical Review Nurse - Concurrent Review. This is a 06+months contract opportunity with long-term potential and is located in U.S(Remote). Please review the job description below and contact me ASAP if you are interested. Job ID:2...Contract workLocal areaImmediate startRemote workWeekend work- ...About This Role The Clinical Review Nurse I is responsible for reviewing and making medical determinations regarding claims to ensure they meet the benefits carried by members. This role is ideal for individuals seeking a flexible, virtual work environment while contributing...Full timeTemporary workFlexible hours
- ...looking for motivated individuals who want to be part of our mission and join our team! As a Utilization Review Nurse, you will utilize your critical thinking skills, clinical expertise and judgement along with established medical criteria to perform first level clinical...Local area
- ...FloMed Infusion is an outpatient infusion clinic offering Medical Infusions and Injections... ...on what we do and who we are, please review our website We are a Florida-based company... ...a Full-Time Clinical Review Registered Nurse to focus on incoming orders and documents...Hourly payFull timeWork at office
- ...Jobs / Clinical Review Nurse - Concurrent Review - J00933 Clinical Review Nurse - Concurrent Review - J00933 Conduct concurrent reviews of patient care for quality and compliance.Collaborate with healthcare providers to ensure appropriate treatment plans.Analyze patient...
- ...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...Work at officeRemote workMonday to Friday
- ...Requires Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing and 2 - 4 years of related experience. Clinical knowledge and ability to analyze... ...Performs medical necessity and clinical reviews of authorization requests to determine medical...Remote workFlexible hours
- ...Position Title: Clinical Review Nurse - Prior Authorization Work Location: Remote (must be clinically licensed in NC, DE, NH, NJ, SC; nationwide sourcing accepted; Compact license preferred) Assignment Duration: 6 months (Possibility to extend or convert) Work...Remote work
$36.49 - $41.49 per hour
...Pay Range: $36.49hr - $41.49hr Job Overview: The Clinical Medical Review Nurse handles day to day review of professional and institutional claims and provider appeals that require medical review to determine if the claim is eligible for benefits and to...Work at officeRemote work- ...Clinical Medical Review Nurse We are seeking Licensed Practical Nurses (LPN) or Registered Nurses (RN) to join the Quality team as Clinical Medical Review Nurses. This is a hybrid contract position requiring both remote work and regular onsite presence at the Canton...Contract workWork at officeRemote work2 days per week3 days per week
- ...Position Title: Clinical Review Nurse - Prior Authorization Work Location: Remote - PST and CST (No CA and NY candidates please) Assignment Duration: 12 Months Work Schedule: Sunday - Thursday Shifts depend on what the team needs. Possible shifts in both...Remote workFlexible hoursShift work
- ...Job Title: Clinical Review Nurse - Prior Authorization - J00927 Address: Various, NJ Job Description: Conduct clinical reviews and authorize prior approvals based on healthcare guidelines. Evaluate medical records and supporting documentation to determine coverage eligibility...Full timeRemote workShift work
$44 per hour
...Clinical Review Nurse - Prior Authorization Various, NV Clinical Review Nurse - Prior Authorization Various, NV All On-site Location: Fully Remote – Prefer Candidates reside in NV, but can reside elsewhere if they have an NV RN License. SHIFT: Training schedule...Permanent employmentContract workLive inRemote workShift 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...Contract workRemote work
$27.02 - $48.55 per hour
...home anywhere within the state of Missouri. This team performs clinical reviews for medical and behavioral health service requests for our... ...standardsEducation/ExperienceRequires Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing and 2 - 4 years of related...Full timePart timeWork at officeRemote workWork from homeMonday to FridayFlexible hours- ...A healthcare organization is seeking a Clinical Review Nurse – Concurrent Review to perform utilization management functions remotely. The role requires conducting concurrent reviews, collaborating with medical teams, and ensuring quality healthcare outcomes. Candidates...Work at officeRemote work
$49.77 - $54.77 per hour
...Pay Range: $49.77hr - $54.77hr Job Overview: Top Required Skills: Current knowledge of clinical practices related to HEDIS and medical record review. Strong organizational skills, including the ability to prioritize responsibilities, maintain attention to detail, and shift...Temporary workWork at officeLocal areaShift work- ...Our client, a Health Insurance company, is looking for a Clinical Medical Review Nurse for their Columbia, MD/Hybrid location. Responsibilities: This role will support medical record retrieval, abstraction, pend management, overreads, and other key activities...Work at officeShift work
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