Remote Clinical QA Coordinator - Utilization Review
AllMed Medical Management
New York, NY
- Remote job
AllMed is seeking a Clinical Quality Assurance Coordinator to perform quality utilization reviews and ensure medical necessity aligns with evidence-based guidelines. This 100% remote role supports Pacific Time Zone operations and may require occasional weekend coverage. The candidate will document findings, uphold accuracy and integrity, and participate in ongoing training and regulatory compliance to deliver high-quality clinical outcomes. #J-18808-Ljbffr AllMed Medical Management
Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Remote Clinical QA Coordinator - Utilization Review in New York, NY vacancy
- AllMed Medical Management is seeking a Clinical Quality Assurance Coordinator, an RN who is detail-driven and passionate about quality. This 100% remote role supports Pacific Time Zone... ...8:00am-4:30pm PST schedule. You will review care against evidence-based guidelines...Remote job
- AllMed is seeking a Clinical Quality Assurance Coordinator (RN) to lead quality utilization reviews and ensure medical necessity in accordance with evidence-based guidelines. The role is 100% remote, requiring a strong knowledge of HIPAA, URAC standards, and regulatory...Remote job
- ...Description: Soleo Health is seeking an Infusion Clinical Review Coordinator to support our Specialty Infusion Pharmacy and work Remotely (USA) . Join us in Simplifying Complex... ...attempts to resolve denials by utilizing nationally recognized criteria for appeal...Remote workImmediate startMonday to FridayFlexible hours
- Clinical Utilization Review Coordinator# Clinical Utilization Review CoordinatorCoffey County Hospital - Burlington, KS 66839## OverviewPosition TypeFull TimeCategoryNursing RN## Description**Job Title:** Clinical Utilization Review Coordinator**Department:** Nursing**...SuggestedWork at office
- Dallas Regional Medical Center is seeking aIST Utilization Review/Case Management professional to coordinate clinical reviews of patient records and participate in UR/Case Management meetings. The role requires MPH or related health care training and medical or dental...Suggested
$60k - $83.2k
...advances performance, and clinical expertise that builds trust... ...Requirements The Clinical Review Coordinator conducts all mandatory case... ...review process. The role is remote work, but you must reside in... ...policies, standards of care, and utilization review criteria applicable...Remote workFull timeContract workFor contractorsWork at officeShift work- Summary Job Description The Advocacy Clinical Review Coordinator investigates member and provider appeals... ...and one (1) year in quality/utilization review; or an LPN with 3 years of appeals... ...Please note: There may be opportunity for remote work within all jobs posted by the...Remote work
- ...JOB SUMMARY The QA Specialist plays an integral role in the review process as they are responsible... ...best practices, and clinical accuracy. In addition,... ...requirements. Receives, coordinates & executes all aspects... ...are provided for remote workspace. ABOUT DANE...Remote workTemporary workWork at officeWork from home
- ...overseeing and performing utilization reviews, prior authorizations, and... ...Director will serve as a key clinical expert, ensuring appropriate... ...discussions. This is a remote position requiring a "roll... ...Nurse Practitioners, Care Coordinators, and Operations, to optimize...Remote workFull timeFlexible hours
- ...Health Corporation is seeking an RN Concurrent Review Nurse to join a remote team delivering inpatient clinical expertise to ensure medically necessary care across... ..., 5+ years inpatient nursing, and 2+ years in utilization management or discharge planning, with an Associate...Remote workWork from homeMonday to FridayWeekend work
- ...A peer review organization is seeking a full-time remote Utilization Management Physician Reviewer. Ideal candidates must hold an MD, DO, or DPM degree with active... ...with management and providing guidance on clinical questions. This is a unique opportunity to work from...Remote workFull timeWork from home
- Comagine Health is seeking a Supervisor, Clinical CM based in Oregon. The role oversees clinical reviewers in utilization review to determine medical necessity, quality, and... ..., and ongoing process improvements in a remote-friendly setting. #J-18808-Ljbffr Comagine HealthRemote job
- ...Seeking a detail-oriented Clinical Data Quality Coordinator, this full-time remote position requires expertise in data analytics... ...in partnership with the QA Manager. Key responsibilities Collaborate with the QA Manager to review and clean data sets while ensuring...Remote workFull timeWork at office
- Dane Street is seeking a QA Specialist in Oregon to oversee reviewer reports, ensure completeness by client due dates, and communicate with clients, reviewers... ...The QA Specialist will evaluate physician reports for clinical rationale, support quality improvements with the...Remote job
- Spectrum Billing Solutions is seeking an ABA Utilization Review Specialist to review clinical data and obtain authorized services for ABA and related treatments. This role offers either remote work or a home-office hybrid setup, with collaboration across clinical staff...Remote jobWork from homeHome office
- Soleo Health is seeking an Infusion Clinical Review Coordinator to support our Specialty Infusion Pharmacy and work remotely in the USA. The role involves researching and providing timely clinical reviews on complex patient cases to secure approvals and reduce denials....Remote job
- Soleo Health is seeking an Infusion Clinical Review Coordinator to support our Specialty Infusion Pharmacy. This role works remotely (USA) with standard Monday-Friday hours 8:30am-5pm MST or PST, focusing on clinical reviews for complex patient cases and denials management...Remote jobMonday to Friday
$60k - $62k
...Job Description Remote- Work From Home, Jackson, Jackson, Michigan, United States... .... Position Overview The Utilization Review Specialist is responsible for all aspects... ...RN Case Manager, or Utilization Review Coordinator). Prior Utilization Review experience...Remote workFull timePart timeWork from homeFlexible hours- ExamWorks, Inc. is seeking a Clinical Quality Assurance Coordinator to review peer reports for quality, accuracy and regulatory compliance. This 100% remote role targets nurses with peer review or... ...exposure. Responsibilities include QA reviews, evidence-based rationales...Remote job
- Resurrection Medical Center in Chicago is seeking a Utilization Management professional to coordinate and review medical records, assess admission criteria, and actively participate in Case Management meetings. The role requires knowledge of federal and state guidelines...Full time
- Leave Your Mark is seeking a Registered Nurse for Utilization Review to support a Michigan health plan client from a home-based setting. The... ..., and length of stay for various services. You will apply clinical judgment and evidence-based criteria, work with the medical...Remote jobWork from home
- AllMed Medical Management is seeking a Clinical Quality Assurance Coordinator. This 100% remote role supports Pacific Time Zone operations, with a Sunday... ...schedule. The position focuses on high-quality utilization reviews and adherence to evidence-based guidelines, HIPAA...Remote job
- Clinical Review Lead Coordinator, LPN/RN General information Date Monday, October 26, 2026 City Remote Country United States Working time Full-time Description & Requirements Join... ...Experience with clinical review, utilization management, or appeals. Knowledge of...Remote workMinimum wageFull timeContract workTemporary workWork experience placement
- The Broadway Ventures LLC team is seeking a skilled Medical Reviewer to evaluate a variety of medical claims, including... ...established criteria. Preferred candidates have BSN and additional clinical and utilization review experience, plus proficiency in MS #J-18808-Ljbffr...Remote jobWork from home
- ...Remote DUR Pharmacist Safe & Cost-Effective Medication Use Work From Home Analyze medication use patterns, apply clinical guidelines, and collaborate with providers all from home. This remote Drug Utilization Review Pharmacist role is ideal for pharmacists who enjoy...Remote jobWork from home
$79.91k - $133.83k
...Role BJC is hiring for a Clinical Documentation Quality Coordinator. This role is responsible for 2nd level reviews, mortalities, prebill,... ...CCDS certified. This is a remote position. Overview... ...deficiencies, and problems utilizing aggregated data and information...Remote workFull timeWork at officeFlexible hours- ...MCMC seeks a Clinical Quality Assurance Coordinator to review peer review reports from home, ensuring quality, accuracy and regulatory... ...and professional report presentation, while supporting QA improvements and client satisfaction in a 100% remote setting. #J-18808-LjbffrRemote work
- ...MES Solutions is seeking a self-driven RN or LPN to join our remote Clinical Quality Assurance team. You will oversee peer review reports, ensure alignment with client agreements and regulatory standards, and maintain high-quality documentation while protecting confidentiality...Remote workMonday to Friday
- ...ResponsibilitiesCoordinates and completes the clinical reviews for all patient medical records while... ...accounts for multiple levels of Utilization Review and Case Management reporting.... ...care for the continuity of treatment. Coordinates discharge referrals as requested by clinical...Local area
- ...leading healthcare solutions company is seeking an experienced Utilization Review Nurse to improve patient care through home-based services.... ...accredited nursing degree and experience in utilization review. Competitive pay and remote flexibility offered. #J-18808-Ljbffr...Remote work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Clinical QA Coordinator - Utilization Review. Be the first to apply!
Related searches
- clinical data coordinator remote New York, NY
- clinical trial coordinator New York, NY
- medical scheduling coordinator New York, NY
- medical coordinator New York, NY
- clinical resource coordinator New York, NY
- clinical coordinator registered nurse New York, NY
- medical equipment coordinator New York, NY
- clinical pharmacy coordinator New York, NY
- clinical data coordinator New York, NY
- medical records coordinator New York, NY



