Remote RN Clinical Reviewer - Utilization & Quality
$45 - $50 per hourkozmetickesluzby.vecnakraska.sk - Jobboard
- Remote job
Greenlife Healthcare Staffing is 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 studies. With a competitive pay of $45 - $50 per hour and benefits including paid vacation and health insurance, this position offers a great work-life balance. Candidates must be graduates of accredited nursing programs with an active New York RN license. #J-18808-Ljbffr kozmetickesluzby.vecnakraska.sk - Jobboard
- Comagine Health seeks Clinical Utilization Review Nurses (RN) to assess medical necessity and quality of care through prospective, concurrent, and retrospective reviews. This full-time, remote position requires Alabama licensure and focuses on compliant, cost-effective...Remote jobQualityFull timeContract work
- ...Authorization Program, the full-time RN Clinical Quality Reviewer will perform comprehensive clinical... ...determination activities, all while working remotely within the US. Key responsibilities... ...to apply clinical judgment within utilization management or prior authorization...Remote workQualityFull time
- ...Clinical Utilization Review Nurses (RN) Based In Alabama Comagine Health is a national, mission-driven, nonprofit... ...that has engaged in health care quality consulting and quality improvement... ...and patient outcomes. Our talented remote workforce spans the country and plays...Remote workQualityFull timeContract work
- ...the first 25 applicants Job Title:Clinical Review Nurse (RN) - Utilization Management Location:Oregon or bordering... ...Collaborate with supervisors on quality assurance and continuous improvement... ...) Clinical Program Coordinator RN *Remote* Clinical Program Coordinator RN *...Remote workQualityContract work
$88k - $93k
Profile Remote work opportunities are available in the following... ...apply. Job Summary The Utilization Management Clinical Review nurse reviews and makes... ...Required: Active, unrestricted RN license U.S. Citizen... ...policyFlag potential quality issues and complaints to Clinical...Remote workQualityContract workTemporary workInterim roleWork at officeLocal areaShift work- ...care continuum to achieve optimal outcomes. The role emphasizes utilization management, discharge planning, and collaboration with a... ...care with physicians, families, and community resources, and ensure efficient, high‑quality care. #J-18808-Ljbffr University HealthQuality
- ...Healthcare Solutions is hiring a Utilization Review Nurse to work remotely. The ideal candidate must hold a valid LPN or RN license and possess strong critical thinking and clinical expertise. Responsibilities... ...reviews, assisting in quality improvement, and providing information...Remote workQuality
$101.72k - $198.36k
...- Ability to work remote, but selected candidate... ...California RN Licensure. Candidates... ...functions: utilization management, care management... ...to provide quality and cost-effective... ...standardized protocols for clinical and non-clinical... ...coordination/care review and management....Remote workQualityContract workWork experience placementWork at officeLocal area- ...enhance the accuracy and quality of patient records, the full-time RN Clinical Documentation Specialist... ...documentation improvement activities remotely, collaborating with providers and utilizing CDI software to ensure... ...conducting follow-up reviews of patient records for...Remote workQualityFull time
- ...Fully Remote Utilization Review Position Setting: Fully Remote – Utilization Review... ...Requirements: Active RN license with Multi-State/... ...experience Minimum 3 years of clinical nursing experience (acute... ...financial data to identify quality improvement opportunities...Remote workQualityFull timeMonday to Friday
- ...seeking an experienced: UTILIZATION MANAGEMENT RN JOB SUMMARY:... ...to ensure high quality and cost-effective utilization... ...Reports to be reviewed by Executive Leadership... ...for members and within clinical guidelines Monitor... ...instructions to remote users. Visit...Remote workQualityWork at office
- ...RN / Medical Reviewer / Remote Job Details Professional Discipline... ...Nurse Specialty : Utilization Review Employment... ...regarding benefits and clinical criteria and assess and monitor... ...Services, Subrogation, Quality of care Referrals, etc.)....Remote workQualityFull timeContract workLocal areaShift work
- UnitedHealth Group is seeking a qualified Utilization Management Nurse to review patient records and craft appeal letters, ensuring... ...while collaborating across teams to deliver high-quality reviews. Requirements include an RN license, 3+ years bedside nursing in acute...Remote jobQualityWork at officeFlexible hours
- ...Prior Authorization, Concurrent Review, and/or Retrospective Review teams, ensuring high‑quality, compliant utilization management for members. The role supports remote work within the continental United... ...holds a nursing degree with RN licensure and 4+ years of UM experience...Remote jobQuality
- HonorHealth in Arizona seeks an Utilization Review RN Specialist to review and monitor utilization for cost-effective, high-quality care. This role ensures medical necessity across... ...collaboration with physicians and care teams. Remote work is available after training. #J-18...Remote jobQuality
- ...POSITION SUMMARY - RN Utilization Review POSITION DUTIES -... ...payers to ensure compliance with clinical guidelines, regulatory requirements... ...~ Skilled experience with remote work LENGTH OF... ...healthcare organizations provide quality patient care that...Remote workQualityTemporary workShift workWeekend work
- Evry Health is seeking an RN Integrated Care... ...coordination and drive quality outcomes across the care... ...high-quality care in a remote environment, with rotating weekend utilization review coverage. The candidate... ...management, 3-5 years clinical experience, and a current...Remote jobQuality
- Comagine Health is seeking a Clinical Manager, Care Management to lead a team in utilization management from a fully remote position in the U.S. The ideal candidate will have extensive... ...and will be responsible for clinical quality, operational performance, and staff...Remote jobQuality
$39 - $40 per hour
...The Judge Group Utilization Management Registered Nurse (RN) Type: 6-Month Contract... ...W2 Location: Remote - but MUST reside... ...and utilization review. You will be responsible... ...receive high-quality, cost-effective treatment... ...services Use clinical expertise to assess...Remote workQualityDaily paidContract workMonday to FridayShift workWeekend work- Comagine Health in Alabama is seeking Clinical Utilization Review Nurses (RN) to assess medical necessity and quality of care through prospective, concurrent, and retrospective... ...utilization reviews. This is a full-time remote role supporting Alabama contracts. You will...Remote jobQualityFull time
$45 - $45.5 per hour
...Senior Analyst Location: REMOTE Duration: 5-6 Months (... ...treatment plan. Utilizes clinical skills to assess, plan... ...that cost effective, quality care is maintained. Provides... ..., and retrospective reviews for inpatient acute care... ...junior team members. RN and current...Remote workQualityContract workImmediate startMonday to FridayAfternoon shift- ...Details: Setting: Fully Remote – Utilization Review Schedule: Full-Time, Monday... ...Requirements: Active RN license with Multi-State/Compact... ...reimbursement, and clinical documentation improvement... ...financial data to identify quality improvement opportunities...Remote workQualityFull timeMonday to Friday
- ...Registered Nurse (RN) Contract... ...seeing a Michigan RN Utilization Manager. This is a 100% remote position in Michigan... ...concurrent and retrospective review of inpatient,... ...RN license ~2 + yr clinical experience - acute... ...Identify and document quality of care issues;...Remote workQualityContract workLocal areaFlexible hours
$38.46 - $43.27 per hour
...Job Description As the Clinical Reviewer, you will be... ...Performing case reviews utilizing regulatory guidelines... ...medical necessity and quality of care issues; formulate... ...office. Ability to work remotely one day per week after... ...required (open to any RN state license). Graduate...Remote workQualityHourly payFull timeFor contractorsWork at office1 day per week$70k - $75k
...Guidehealth leverages remotely-embedded Healthguides™... ...partners to deliver high-quality healthcare focused on... ...Description The Utilization Management Registered... ...performing utilization review activities in... ...and accurately document clinical information from medical...Remote workQualityBi-weekly payFull timeTemporary workFor contractorsLocal areaWork from home$72.8k - $130k
...occasional opportunity for remote work based on business needs. As a Sr Utilization Management Nurse in... ..., and promoting quality patient care. Responsibilities... ...discuss care details, reviewing clinical information for... ...~ Registered Nurse (RN) with a current, active...Remote workQualityMinimum wageFull timeWork experience placementCasual workLive inWork at officeLocal area- A leading organization in healthcare quality is seeking a Clinical Quality Reviewer to review clinical cases and identify potential quality or safety concerns. This remote position is ideal for licensed clinical professionals with a strong analytical mindset and a minimum...Remote jobQuality
- ...Utilization Review And Management (Um) Component Program The utilization... ...facilities are medically necessary, clinically appropriate, evidence-based,... ...our commitment to quality, safety, and excellence in healthcare... ...This is an in-office, no remote work capability position...Remote workQualityWork at office
$60.2k - $107.4k
...Utilization Management & Clinical Validation Rn Optum is a global organization that delivers care, aided by technology... ...will accurately and efficiently review and extract pertinent case details... ...as needed Adheres to quality and productivity expectations Participate...Remote jobQualityMinimum wageFull timeWork experience placementLocal area$35 - $37 per hour
...The Judge Group. Job Title: Remote Registered Nurse (RN) - Temp to Perm Pay Rate: $... ...responsible for completing quality audits of physician case reviews, supporting the clinical aspects of the review... ...whether practicing or not. Utilization Review experience is helpful...Remote jobQualityPermanent employmentFull timeTemporary workMonday to Friday
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