Remote Care Review Clinician (RN/LPN)
Molina Healthcare of Illinois
- Remote job
Molina Healthcare is seeking a Care Review Clinician (RN or LPN) for a remote, full-time position operating 8a-5p Pacific Time, Monday through Friday. You will support clinical member services review processes, verify medical necessity, and ensure alignment with established guidelines and policies to promote quality and cost-effective care. In this role you will collaborate with multidisciplinary teams to drive member outcomes, perform prior authorization reviews, and adhere to utilization #J-18808-Ljbffr Molina Healthcare
$30 - $35 per hour
...it easier. We help deliver care beyond traditional... ...role requires professional review and interpretation of relevant... ...Licensed Practical Nurse (LPN) licence, or a Registered Nurse (RN) licence in the state of practice... ...opportunities ─ from remote‑friendly to hybrid and in‑...Remote workHourly payTemporary workWork at officeLocal areaFlexible hoursNight shift- ...Hiring Event Molina Healthcare is looking for dedicated Care Managers (RN, LPN, BH licensed) across Illinois to provide compassionate,... ...a difference, we're hiring for: ~ Care Manager & Care Review Clinicians Register now for our virtual event on October 28 to...Remote work
- ...(2pm to 11pm Eastern). The Utilization Review Clinician is responsible for reviewing medical records... ...assessments to help prevent acute care readmissions. In this role, you will also... ...clinical nursing or therapy experience Active RN, OT, or PT license Preferred...Remote jobFull timeWork experience placementWork at officeWorldwideMonday to FridayShift work
- 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...Remote job
$77.91k - $116.86k
...breaking the mold in conventional health care, committed to serving seniors and... ...Alignment Health is seeking an inpatient review nurse to join the remote utilization management team. As an... ...active, valid, and unrestricted LVN or RN license in California (Non-Compact)...Remote workFull timeImmediate startMonday to Friday- ...Provides support for clinical member services review assessment processes. Responsible for... ...desired outcomes through integrated delivery of care across the continuum. Contributes to... ...education and experience. Registered Nurse (RN). License must be active and unrestricted...Remote jobWork at office
- MES Solutions is seeking a Clinical Quality Assurance Coordinator (RN/LPN) to review peer reports and ensure accuracy, compliance with client agreements, and regulatory standards. This 100% remote role aligns clinical expertise with quality control across cases. The position...Remote jobMonday to Friday
- ...Allegheny Health Network seeks an RN Utilization Review professional to obtain pre-... ...for a seamless patient care continuum. You will liaise with third party payers, clinicians and care teams to ensure appropriate... ...timely approvals. This remote role requires PA RN...Remote work
$32.13 - $48.2 per hour
...Responsibilities: Provide care in accordance with... ...Expectations: Registered Nurse (RN): Holds full... ...care plans. Supervises LPN and nursing assistant clinical... ...and documentation with RN review as appropriate. Remote Type Salary Range: $32...Remote workDaily paidRelocation packageShift work- ...generation of exceptional health care professionals. With more than 1... ...The Registered Nurse (RN) provides professional telephone... ...providers, inpatient admissions Review laboratory/test results; recognize... ...whose positions are 100% remote are exempt from these requirements...Remote workTemporary workFor contractors
- ...Inpatient Utilization Management Clinician to evaluate inpatient medical... ...discharge planning across care teams. This fully remote, full-time role requires an active RN license, nursing degree, and experience... ...management to ensure timely reviews, document outcomes, and...Remote workFull time
- Fully remote position supporting patients during Annual Wellness Visits... ...comprehensive AWV charts and review patient histories, medications... ...We're Looking For: Active RN or LPN/LVN compact license and 3+ years... ...patient-centered work closing care gaps for Medicare Advantage...Remote jobPart timeFlexible hours
- Centene Corporation is seeking a skilled clinician to perform clinical reviews and assess care for mental health and substance use. This remote role requires an active Washington RN or Compact RN license and offers weekday hours with weekend/holiday rotation. You will...Remote workWeekend workWeekday work
- ...Medication Therapy Management (MTM) Clinician is responsible for providing... ...to, Comprehensive Medication Reviews, Targeted Interventions,... ..., and Transitions in Care. Conduct proactive patient... ...Active Florida Registered (RN, LPN, NP) Requires three (3) years...Full timeWork at office
$83.2k
...Job Title: Virtual Care Nurses (RN, LPN/LVN) Location: 100% Remote - United States Employment Type: Full-Time W2 Hourly Compensation: RN $40... ...support provider efficiency and CMS compliance. · Review and summarize with patients in face-to-face virtual...Remote workHourly payFull timeWork from homeHome officeFlexible hours- Centene is seeking a remote Behavioral Health Review clinician with licensed credentials to assess and authorize mental... ...to ensure appropriate levels of care and discharge planning. The ideal... ...such as LCSW/LMHC/LPC/LMFT/LMHP or RN are required. #J-18808-Ljbffr Santa...Remote job
$65k - $85k
...Concierge Home Care | Remote Opportunity | Growth Opportunities | Increased Earning Potential... ...for an experienced Utilization Review Specialist (RN) to join our remote home health team.... ...Directors, Clinical Managers, and field clinicians Support quality assurance and...Remote workMonday to FridayWeekend workWeekday work- CVS Health Corporation is seeking an RN Concurrent Review Nurse to join a remote team delivering inpatient clinical expertise to ensure medically necessary care across the continuum. This role offers work-from-home scheduling, Monday-Friday, with some weekend coverage....Remote jobWork from homeMonday to FridayWeekend work
$15k
...HIRING BONUSES - FULL TIME RN $15,000 and FULL TIME LPN $7,500! NIGHTS WEEK DAY ONLY... ...to provide direct nursing care to the patients and to... ...infection control procedures. Review care plans to ensure that... ...with local staff, remote staff, and outside agencies...Remote workFull timeLocal areaShift workNight shiftWeekend work- RN or LPN - Regional Quality Assurance Nurse Location: Remote with travel to facilities as needed. Des Moines, Kansas City, Omaha... ...maintaining high standards of care, compliance, and documentation... ...Responsibilities Perform chart audits, QA reviews, and regulatory documentation...Remote jobFull time
- Optum is seeking a remote IRR Clinical Claim Review Nurse to perform clinical review of claims against medical records and guidelines. The role requires an active RN license, 2+ years of acute care clinical experience, and 1+ year in claim review or related areas. You...Remote jobWork from home
$41 - $68 per hour
...Position: Mobile Dispensary LPN or RN Location: Pierce and King... ...Join Our Mission! We Care Daily Clinics (WCDC) is a warm... ...regulatory audits and internal reviews to ensure ongoing compliance.... ...communities, often in underserved or remote areas. Adaptability, problem-solving...Remote workWork at officeLocal areaShift work- Medical Director Services PC is seeking compassionate RNs or LPNs for a Hybrid RN/LPN - Patient Monitoring & Care - Remote role. You will monitor patients' vitals via our RPM platform, review biometric data, and identify abnormal trends while collaborating with...Remote jobFlexible hours
- ...staff, access to our premier health care provider networks, and our... ...Job Title: Precertification Nurse - LPN/RN Full time: Monday to Friday Location: Remote. Will need to be in Hamilton NJ office... .../ No-Fault - Preferred InterQual/Review Manager/CERME CPT and ICD-9/ICD-10...Remote jobFull timeWork at officeMonday to Friday
$70k
...Are you an RN or LPN looking for an opportunity in focused wound care? Integrated Wound Care is seeking a compassionate and... ...position is full time, and is fully remote. Candidates must reside in the... ...data entry ~ Clinical chart reviews and audits ~ Generating spreadsheets...Remote workFull timeFor contractorsWork at office- Weekend Baylor Program RN's/LPN's ($10,000 sign on bonus) Join the The... ...only locally owned, long‑term care facility in the area. We are... ...including vital signs and medication review Administer medication as... ...Manor at Blue Water Bay Work Remotely No remote work; position is...Remote workFull timeRelocation packageFlexible hoursShift workWeekend workAfternoon shift
- ...delivering exceptional patient care. As our practice continues to... ...team. This role is ideal for an RN or LPN who enjoys patient education,... ...findings to the physician for review and direction. Coordinate... ...Friday afternoons off! Hybrid remote work may be available following...Remote workFull timePrivate practiceWork at officeMonday to FridayFlexible hoursWeekend work
$62.4k - $66.56k
...the Charles Lea Center as an LPN/RN Nurse At the Charles Lea Center... ..., providing hands-on care, and serving as a healthcare resource... ...Complete medication audits and reviews as assigned. Conduct medication... ...duties may be conducted in a remote setting with the flexibility...Remote workHourly payFull timeLocal areaMonday to FridayFlexible hoursShift workAfternoon shift- Job Title: Care Review Clinician I Schedule: Varies Sunday-Saturday 6am-9pm PST Location: Remote, CA Duration: 03+ Months Day to Day Responsibilities: Medical necessity clinical... ...performing prior authorization review, CA RN license KNOWLEDGE/SKILLS/ABILITIES: • Assesses...Remote work
- Hybrid RN/LPN - Patient Monitoring & Care - Remote Join Our Growing Clinical Team! We are seeking compassionate, detail-oriented Registered Nurses (RNs)... ...signs through our Remote Patient Monitoring platform. Review blood pressure, pulse, oxygen saturation, weight,...Remote workHome officeFlexible hoursShift work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Care Review Clinician (RN/LPN). Be the first to apply!
- outpatient clinician New York, NY
- mental health clinician New York, NY
- intake clinician New York, NY
- crisis clinician New York, NY
- school based clinician New York, NY
- bilingual clinician New York, NY
- clinician New York, NY
- licensed mental health clinician New York, NY
- injection rn New York, NY
- pediatric icu rn New York, NY




