Remote RN - Clinical Quality & Peer Review Lead
MES Solutions, LLC
- Remote job
MES Solutions, LLC is seeking a Clinical Quality Assurance Coordinator (RN) to perform QA reviews of peer review reports from home. You will ensure evidence-based rationales, adherence to client specs, and compliance with state and federal mandates. The role requires strong medical knowledge and precise documentation. The position is fully remote with a schedule Sunday to Wednesday, 7:00am–5:30pm EST and one day 10:00am–8:30pm EST. #J-18808-Ljbffr MES Solutions, LLC
- Optum in El Segundo is seeking a Clinical Manager to oversee the QI Nurses in the Grievance/Peer Review Lane. This role involves... ...grievance processes and ensuring quality by collaborating with clinical staff. Flexibility to work remotely is provided. Ideal candidates will...Remote jobQuality
- Network Medical Review is seeking a Clinical Quality Assurance Coordinator. This role, designed for licensed nursing professionals, allows you to work 100% remote while ensuring the quality of peer review case reports. Responsibilities include reviewing reports for compliance...Remote jobQuality
$85k - $92k
...$41–$44/hr Location: Remote Schedule: Must work AZ... ...license: RN Minimum 3+ years clinical experience (med/surg and... ...HIGHLY DESIRED) Clinical Quality / Utilization Review / Case Review experience... ...Issues (PQIs) Support peer review + quality improvement...Remote workQualityHourly payDay shift- ...healthcare consulting firm is seeking a full-time remote Peer Reviewer (Non-physician) to provide clinical expertise for comprehensive peer reviews. Candidates... ...comprehensive health benefits and a dynamic work environment focused on quality healthcare solutions. #J-18808-LjbffrRemote workQualityFull time
- ...organization in Sitka, Alaska, seeks a Medical Staff Peer Review & Projects Coordinator. This role involves... ...ensuring compliance with regulations, and analyzing clinical performance data. The ideal candidate has a current RN license in Alaska, a BSN, and 5 years of...Quality
- ...are partnering with a leading organization supporting... ...program to identify a Clinical Quality Reviewer. This role focuses on... ...recommendations Support peer review processes and... ...as a Registered Nurse (RN) or Licensed Clinical... ...environment Other Information Remote or onsite depending on...Remote workQualityWork at officeHome office
- Acentra Health is seeking a Supervisor of Clinical Review to manage Utilization Management activities and ensure high-quality clinical programs. This position requires strong... ...regulatory standards. Applicants must hold an active RN or LPN/LVN license with at least 2 years of...Remote jobQuality
- ...Nurse with active licensure and minimum 3 years of clinical experience for a remote position. Candidates must have strong clinical... ...background clearance. This role involves reviewing medical records, identifying quality issues, and supporting quality improvement initiatives...Remote workQuality
$85k - $92k
...TEEMA Solutions Group is seeking a Clinical Quality Reviewer to support a federal healthcare program. This... .... Candidates must have a valid RN or LCSW license with at least three years... ...clinical experience. The position may be remote or onsite based on business requirements...Remote workQualityWork at officeHome office- ...Comagine Health is seeking a Clinical Utilization Review Nurse (RN) to work remotely. This role involves assessing the necessity and quality of healthcare services through various review methods, ensuring compliance with clinical criteria. The ideal candidate must hold...Remote workQuality
- ...COMAGINE HEALTH is seeking a Clinical Utilization Review Nurse (RN) to conduct utilization management reviews. This full-time role supports high-quality care delivery while ensuring compliance... ...relevant experience. The position is remote, allowing work from any location...Remote workQualityFull time
- ...Comagine Health is looking for a Clinical Utilization Review Nurse (RN) to perform remote assessments on the medical necessity of healthcare services. This full... ...and ensuring compliance with clinical policies for quality care. Candidates should possess a BA/BS in...Remote workQualityFull time
- TEEMA Solutions Group is looking for a Clinical Quality Reviewer to support a large-scale federal healthcare... ...ideal candidate will have an active RN or LCSW license, at least 3 years of... ...skills. This role offers flexibility with remote or onsite work options, depending on...Remote jobQuality
$45 - $50 per hour
...looking for a dedicated Registered Nurse Clinical Reviewer for a fully remote position in New York. This role involves conducting utilization and quality reviews and contributing to clinical... ...programs with an active New York RN license. #J-18808-Ljbffr kozmetickesluzby...Remote jobQualityHourly pay$28.37 - $35 per hour
Acentra Health is hiring a Clinical Reviewer (LPN, LVN, RN) to review medical records against criteria. This remote position demands strong clinical assessment skills. Responsibilities... ...cases, adjusting workload as needed, and quality monitoring. Required qualifications include...Remote jobQualityHourly pay- ...organization that has engaged in health care quality consulting and quality improvement... ...and patient outcomes. Our talented remote workforce spans the country and plays... ...Overview We are seeking an RN to perform Clinical Review work and QIDP reviews work. Team member...Remote workQualityContract work
$80k - $90k
...organization. Machinify is a leading healthcare... ...industry-leading speed, quality, and accuracy. We’re reshaping... ...*** Performs clinical reviews on medical records to... ...work independently in remote setting with minimum supervision... ...* Active unrestricted RN license #J-18808-...Remote workQualityFlexible hours$31 - $35 per hour
...Clinical Review & Correspondence RN The Clinical Review & Correspondence RN plays a... ...you will help support high-quality care, regulatory compliance... ...applications This is a 100% remote role, and requires robust... ...2023 & 2024. Backed by leading investors such as...Remote workQualityFull timeFlexible hoursShift work$26 - $28 per hour
...Clinical Reviewer, RN/LPN (Remote - TN) Essential Duties and Responsibilities: Review requests for services including admission, discharges and... ...a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external...Remote jobQualityMinimum wageContract workTemporary workWork experience placement$62.7k - $100.4k
Job Summary Clinical Care Reviewer II is responsible for processing medical necessity reviews for appropriateness... ...standards Identify and refer quality issues to Quality Improvement Identify... ...of an accredited registered nursing (RN) degree program required Three (3) years...Remote jobQualityWork at office- ...located in Atlanta, GA, is seeking a Clinical Quality Assurance Coordinator for a fully remote position. In this role, you will ensure top-quality peer review case reports while adhering to... ...The ideal candidate will be an active RN or LPN with strong clinical skills and...Remote workQualityWork from home
- A healthcare solutions company in McLean seeks experienced peer reviewers with at least 5 years in clinical settings. Responsibilities include reviewing medical records, assessing clinical guidelines, and providing improvement recommendations. Candidates must have an active...Remote jobWork from homeFlexible hours
- ...Job Summary Provides clinical leadership and... ...medical practices, remote patient monitoring... ...reports, including quality improvement. Manages... ...activities for employees. Reviews progress of work... ...of tasks. Leads group discussions,... ...clinical experience as an RN in an ambulatory care...Remote workQualityWork at officeWeekend workAfternoon shift
- UnitedHealth Group is looking for a Psychologist Peer Review to apply clinical criteria for treatment coverage while working flexibly from anywhere in the U.S. In this role, you will be responsible for outpatient treatment reviews, participating in peer consultations, and...Remote job
- ...A healthcare organization is seeking a Clinical Review Nurse – Concurrent Review to perform utilization management functions remotely. The role requires conducting concurrent reviews... ...with medical teams, and ensuring quality healthcare outcomes. Candidates should have...Remote workQualityWork at office
- ...MES Solutions is seeking a self-driven Registered Nurse (RN) for the remote role of Clinical Quality Assurance Coordinator. This position involves ensuring peer review reports maintain exceptional quality and integrity, aligning with regulatory standards. The ideal candidate...Remote workQuality
- ...is seeking an experienced clinical manager in El Segundo, CA... ...within the Grievance/Peer Review Lane, collaborating closely... ...to manage grievances and quality issues. Flexibility to work remotely is offered. The ideal candidate... ...nursing degree, a valid RN or LVN license, and...Remote jobQuality
- SPECTRAFORCE is seeking a Clinical Quality Reviewer to support PQI investigations with remote health plan/IPA experience. The role requires extensive clinical knowledge across hospital and behavioral health settings and reports to the Manager, Clinical Quality Review. Responsibilities...Remote jobQuality
- MES Solutions in Norwood, MA is seeking a Clinical Quality Assurance Coordinator to ensure high-quality peer review case reports. This fully remote role offers flexible hours primarily... ...integrity. Candidates must possess an active RN license, at least two years of...Remote jobQualityFlexible hours
- MES Solutions is searching for a motivated Registered Nurse (RN) for the remote role of Clinical Quality Assurance Coordinator. This position requires clinical expertise to ensure that Peer Review case reports meet regulatory standards and quality expectations. The ideal...Remote jobQualityFlexible hours
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