Clinical Medical Review Nurse
Lumen Solutions Group Inc.
Clinical Medical Review NurseWe 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, MD office. Nurses will support the review and abstraction of medical records to ensure accuracy and compliance with quality standards.Key responsibilities include:Review and abstract data from medical recordsExtract relevant clinical data using Electronic Medical Record (EMR) systemsParticipate in periodic onsite provider visits (minimum once per month) to retrieve medical recordsAttend mandatory in-person training in January and again in June or JulyUse basic Excel to enter, track, and manage clinical dataWork collaboratively with internal QA and clinical teamsQualifications:Active RN, LPN, or Compact Nursing License (must be current and in good standing)Minimum 5 years of clinical experienceExperience with medical record review and data abstractionProficiency with Electronic Medical Record (EMR) systemsBasic knowledge of Microsoft ExcelMust reside in the state of Maryland (MD)Willingness to be onsite 2–3 days/week in Canton, MD and travel to provider offices as neededPreferred qualifications:HEDIS experience (preferred but not required)Nursing degree (Associate or Bachelor's – a plus)
- ...Clinical Medical Review NurseAmpcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are... ...and effect rationale (inquisitive).Qualifications:Registered Nurse (RN) – active state or compact license.4 years' clinical experience...MedicalRemote 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...MedicalContract workWork at officeRemote work2 days per week3 days per week
$36.49 - $41.49 per hour
...49hr - $41.49hr Responsibilities Review, research, and analyze professional and institutional claims using clinical judgment and medical policies for accurate adjudication.... ...Participate in medical policy meetings, nursing forums, and review sessions with medical...MedicalWork at office- ...Clinical Medical Review Nurse Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are in search of a highly motivated candidate to join our talented team. The Clinical Medical Review Nurse handles day-to-day...MedicalWork at officeImmediate start
$45 per hour
...Center, on the campus of UM St. Joseph Medical Center, in Towson, MD. The clinic hours are 7:00am to 4:30pm, Monday... ...the minimum role for all nurses at UMMC who have greater than 12 months... ...applicable): Shift Differential Review the 2025-2026 UMMS Benefits Guide...MedicalWork experience placementReliefTrial periodMonday to FridayShift workNight shiftWeekend work$84.09k - $120.12k
...Comprehensive health coverage: medical, dental, vision, prescription... ...for appropriate care by reviewing admissions and service requests... ...in even the most challenging clinical situations. Support the frontline... ...: ~ Registered Nurse credentialed from the Maryland...MedicalFull timeLocal areaRemote workMonday to FridayWeekend workDay shift$1,523 - $1,618 per week
...Registered Nurse (RN) | Utilization Review Location: Baltimore, MD Agency: GQR Healthcare Pay: $1,523 to $1,618 per week Shift... ...assignment. Benefits: ~ Day 1 Insurance ~ Cigna medical, MetLife dental and vision insurance ~ License reimbursement...MedicalHourly payWeekly payFull timeContract workImmediate startShift work$1,523 - $1,618 per week
...Registered Nurse (RN) | Utilization Review Location: Baltimore, MD Agency: GQR Healthcare Pay: $1,523 to $1,618 per week Shift... ...assignment. Benefits: ~ Day 1 Insurance ~ Cigna medical, MetLife dental and vision insurance ~ License reimbursement...MedicalHourly payWeekly payFull timeContract workImmediate startShift work$80k - $95k
...Medical Review Nurse III Fully Remote Windsor Mill, MD Overview Salary Range $80,000.00 - $95,000.00 Salary Position Type Full Time... ...Coverage Determinations, utilization/practice guidelines, and clinical review judgment. Provides professional assessment, planning,...MedicalFull timeContract workFor contractorsLive inWork at officeLocal areaRemote work$40.12 - $62.19 per hour
...Utilization Review Nurse RN ~Baltimore, MD ~SINAI HOSPITAL ~UTILIZATION REVIEW... ...reimbursement. Key Responsibilities: Medical necessity review of patient stays and referral... ...-based practice councils and advanced clinical education support — improving both...MedicalFull timeShift workWeekend workDay shift$50 per hour
...Sinai Hospital's Utilization Review operates as a distinct specialty... ...service line of physician advisors, nurses, and support staff who ensure hospital stays are clinically appropriate and fully covered... ...* Key Responsibilities: Medical necessity review of patient...MedicalReliefLive in$40.12 - $62.19 per hour
...Sunday role Summary: The Utilization Review Nurse RN conducts initial, concurrent and retrospective chart review for clinical, financial and resource utilization... ...Responsibilities Include: Reviews the medical record by applying utilization review criteria...MedicalWeekend work$1,660 - $1,809 per week
...Registered Nurse (RN) | Progressive Care Unit Location: Baltimore... ...by MIT Sloan Management Review. No matter if you want to explore... ...healthcare system · Day-1 medical benefits that last up to 30... ...6 months · 24/7 support · Clinical support throughout your assignment...MedicalFull timeContract workLocal areaImmediate startShift work- ...RN Clinical Manager Mountain View Surgery Center Gilbert is an... ...direction and evaluation of nursing practice to promote safe, efficient... ...objectives of the Center. Review and revise these in... ...with the center staff and the medical staff. Establish, maintain...MedicalTemporary workWork at officeLocal areaMonday to FridayFlexible hours
- ...Shock Trauma Outpatient Pavilion (STOP) Nurse The Shock Trauma Outpatient Pavilion (STOP) at the University of Maryland Medical Center is a specialized, multidisciplinary clinic dedicated to providing comprehensive follow-up care for trauma patients recovering from...MedicalWork experience placementTrial period
$27.7 - $42.94 per hour
...About the Role: ~ The Clinical Performance Liaison-Licensed Practical Nurse (LPN) provides multi site clinical support across LifeBridge Health Medical Group practices. This role rotates throughout... .... Performs onsite workflow reviews, observing intake processes,...Medical- ...Healthcare Center, a 75-bed skilled nursing, long-term care, and memory... ...Nurse (RN) to serve as Clinical Manager overseeing our skilled... ...escalation of clinical concerns. Review physician orders, treatment plans, care plans, medication-related concerns, and other clinical...MedicalLocal area
- Ampcus Inc. is seeking a Utilization Management Specialist (Remote) to review medical necessity and authorization for clinical services. The role emphasizes clinical nursing expertise, care management experience, and adherence to guidelines and policies. The position requires...MedicalRemote job
- ...experienced Utilization Management Nurse to support admitting teams in... .... The role requires robust clinical judgment, collaboration with... .... The position involves reviewing clinical information with InterQual... ...maintaining regulatory #J-18808-Ljbffr Boston Medical CenterMedical
$37.15 - $57.58 per hour
...Registered Nurse (RN) - Grace Medical Center - A.C.T. ~Baltimore, MD ~GRACE MEDICAL CENTER... ...unit manager, this role provides direct clinical patient care. The role will assume responsibility... ...timely follow-up. Engages in peer review process Collaborates with multi-...MedicalHourly payPart timeShift workDay shift$68.28k - $110.27k
...determinations through the utilization review process supporting quality,... .... Responsible for analyzing clinical information and performing... ...to identify appropriate medical necessity, length of stay, and... ...Education Bachelor of Science in Nursing (BSN) OR Associate of Science...MedicalFull timeLocal area$37 - $54.18 per hour
...University of Maryland St. Joseph Medical Center, you’re coming to more... ...with solid knowledge and clinical skills; engaged in advancing own... ...Qualifications Licensure as a Registered Nurse in the state of Maryland, or... ...Compensation (if applicable): Review the 2025-2026 UMMS Benefits...Medical$39.35 - $54.05 per hour
...practices with solid knowledge and clinical skills; engaged in advancing... ...procedures. It also supports medical overflow. Ratio: 4:1 - 5:1... ...team includes RNs, student nurses, PCTs, and exercise... ...for a $20,000 sign‑on bonus. Review the 2025‑2026 UMMS Benefits Guide...MedicalRelocation packageShift workWeekend work$39.35 - $54.05 per hour
...over two years experience. The nurse will utilize this time to... ...Responsibilities and Tasks Clinical Practice/Care Delivery Focus... ...Provides feedback in peer review as requested. Qualifications... ...post first day of employment. University of Maryland Medical CenterMedicalRelocation packageFlexible hours- ...Senior Clinical Nurse II - Virtual Heart Failure Transitional Care Bridge Clinic Join an innovative interdisciplinary team transforming... ...Conduct clinical assessments, symptom evaluation, medication review, patient education, and ongoing monitoring through remote patient...MedicalRemote work
$39.35 - $54.05 per hour
...practices with solid knowledge and clinical skills; engaged in advancing... ...Licensure as a Registered Nurse in the state of Maryland, or eligible... .... Compensation: Pay Range: $39.35 - $54.05 Review the 2025-2026 UMMS Benefits Guide University of Maryland Medical CenterMedicalRelocation packageNight shift$64.6k - $113.3k
We are seeking a Clinical Nurse who will support the Outpatient Parenteral Antimicrobial Therapy... ...Hospital and Johns Hopkins Bayview Medical Center, including providing support and,... ...directed from office support staff, lab review, coordination of home care, and coordination...MedicalFull timeWork at office- ...considered the minimum role for all nurses who have greater than 12... ...care to patients within a clinical specialty as a fully effective... .... Provides feedback in peer review as requested. Provides direct... ...ACLS, NRP. #J-18808-Ljbffr University of Maryland Medical SystemMedicalWork experience placement
- ...scope of practice of Radiology Nursing occurs within the framework... ...nursing skills and implements medical treatment plan. Provides... ...Procedures as needed; reviews discharge instructions with patients... ...staff by serving as a clinical resource. Conducts departmental...MedicalImmediate start
- ...Nurse Leader Position The University of Maryland Medical Center is at the vital core of Maryland's health care system and... ...designed for the nurse who is a clinical and professional leader at the unit... ...; leads unit-based peer review processes. 2. Actively engaged...MedicalWork experience placement
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