Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Remote RN - Clinical Case Review & Operations (256033)

$48 - $65 per hour

Medix™

Remote Registered Nurse – Clinical Review

Fully Remote | $48–$65/hr | Monday–Friday, 9:00 AM–6:00 PM ET

Medix is supporting a healthcare technology organization that is adding experienced RNs to its clinical team.

This is a hands‑on remote nursing role. You’ll work through clinical cases, review the information available, identify what is missing, determine the appropriate next step, and escalat when needed.

The work can touch prior authorization, utilization review, care coordination, patient access, and other clinical workflows, but this is not a traditional UM-only position.

What you’ll do

  • Review patient records, clinical notes, orders, medications, labs, imaging, and other supporting documentation
  • Identify missing or conflicting information and follow up when additional documentation is needed
  • Use clinical judgment and established guidelines to determine next steps
  • Escalate cases that need additional clinical review
  • Support authorization, utilization, care coordination, and patient-access workflows
  • Document findings and decisions clearly
  • Manage a steady volume of cases in a remote environment
  • Work with clinical and operations teams to resolve issues and improve workflows
  • Help with process, documentation, or training improvements as you become familiar with the work

What we’re looking for

  • Active RN license
  • BSN preferred
  • 3+ years of RN experience
  • Strong clinical judgment
  • Comfortable working independently
  • Able to manage multiple cases and priorities at once
  • Comfortable learning new systems and workflows
  • Able to recognize when something does not look right and needs to be escalated

Experience in telehealth, virtual care, telephone triage, care management, clinical review, utilization review, prior authorization, population health, chart review, or digital health is especially relevant.

We’re also interested in nurses who have taken on responsibilities like precepting, charge coverage, auditing, training, or serving as a go-to resource for other nurses.

Pay: $48–$65/hour, based on experience

Schedule: Monday–Friday, 9:00 AM–6:00 PM ET

Location: Fully remote within the U.S.

Employment: Long-term W-2 contract through Medix

Benefits

  • Eligibility after 30 days

Equipment

  • Company-issued equipment provided

Start timing: Typically around two weeks from offer, with some flexibility

#J-18808-Ljbffr
Vacancy posted 54 minutes ago
Similar jobs that could be interesting for youBased on the Remote RN - Clinical Case Review & Operations (256033) in New York, NY vacancy
  • $2,300 per month

     ...The Clinical Review Nurse (RN) supports the organization’s care management function...  ...for members. This is a remote role open to candidates...  ...IMPACT: Clinical Review & Case Management Perform prospective...  ...regulations governing TPA operations a plus. Strong clinical... 
    Remote work
    Operations
    Part time
    Work at office

    MotivHealth

    Utah
    8 hours ago
  • $31 - $35 per hour

     ...Clinical Review & Correspondence RN The Clinical Review & Correspondence RN plays a...  ...supporting utilization management operations by conducting medical...  ...management and case management programs integrate...  ...applications This is a 100% remote role, and requires robust... 
    Remote work
    Operations
    Full time
    Flexible hours
    Shift work

    Venturefizz Product Management Community

    United States
    11 hours ago
  • $82.4k - $110k

     ...Clinical Review RN, Oncology AI Review Position Summary Natera is...  ...reimbursement and coverage operations. This role will serve as...  ...reviewing complex oncology cases, auditing AI-generated clinical...  ...of labor considerations. Remote USA $82,400—$110,000 USD... 
    Remote work
    Operations
    Full time
    Work at office
    Immediate start
    Worldwide

    Natera

    Remote
    3 days ago
  •  ...determine the viability of the claim for further review in a production environment. Primary Responsibilities: Clinical Case Reviews - 75% Perform clinical review of...  ...Examine, assess, and document business operations and procedures to ensure data integrity, data... 
    Remote job
    Operations
    Contract work
    Work at office
    Local area
    Monday to Friday

    UnitedHealthcare

    San Juan, TX
    5 days ago
  •  ...Medix is seeking a fully remote Registered Nurse to perform clinical review and telehealth–style assessments from anywhere in the United States. You will review...  ...processes. The role requires 3+ years of RN experience, an active license, and strong clinical judgment... 
    Remote work
    Operations
    Long term contract
    Monday to Friday

    Medix™

    New York, NY
    54 minutes ago
  • $40 - $43 per hour

     ...Description Title: Clinical Review Nurse – Medicaid Denial...  ...Letters Location: Fully Remote – Florida Pay: $40...  ...relevant clinical and case information to support...  ...Registered Nurse (RN) license. Licensed...  ...Medicaid health plan operations. Prior experience working... 
    Remote work
    Operations
    Hourly pay
    Flexible hours
    Shift work

    A-Line

    Orlando, FL
    2 days ago
  •  ...practice and company procedures. Review and approve patient...  ...to have and maintain a valid clinical license, per state requirements...  ...approval from the vice president operations or regional president...  ...than for designated full-time remote positions, in-office attendance... 
    Remote work
    Operations
    Full time
    Temporary work
    Work at office
    Local area
    Immediate start
    Flexible hours

    Enhabit Home Health & Hospice

    Grapevine, TX
    1 day ago
  • $29 - $52 per hour

     ...Clinical Review Clinician Optum is a global organization that delivers care, aided by technology...  ...of meeting Optum's core business operations Complete analysis of billing and departmental...  ...'s degree ~ Active and unrestricted RN license OR LPN in the state of residence... 
    Remote job
    Operations
    Hourly pay
    Minimum wage
    Full time
    Temporary work
    Work experience placement
    Local area

    Genoa Telepsychiatry

    Minneapolis, MN
    4 days ago
  • $28.5 per hour

     ...Job Title: Clinical Quality Assurance Nurse Pay: see...  ...Responsible for ensuring case reports are of the...  ...Perform quality assurance review of peer review reports,...  ...compliance. Must be able to operate a general computer, fax...  ...This is a fully remote position.... 
    Remote work
    Operations
    Contract work
    Temporary work

    TEKsystems

    Dallas, TX
    54 minutes ago
  • $85k - $95k

     ...The Registered Nurse – Clinical Case Consultant serves as...  ...interdisciplinary team members. Review complex member cases...  .... Evaluate field operations and identify...  ...unrestricted Registered Nurse (RN) license in the State...  ...a combination of remote work, office-based... 
    Remote work
    Operations
    Full time
    Temporary work
    Work at office
    Local area
    Monday to Friday
    Flexible hours
    Afternoon shift

    Pacific Health Group

    San Diego, CA
    2 days ago
  • $65k - $75k

     ...leader in intelligent operations and transformation, serving...  ...Performs utilization review of cases to determine if the...  .... • Performs clinical reviews according to the...  ...Qualifications • RN, LPN/LVN graduate from...  ...00pm CST Location: Remote Compensation Disclosure... 
    Remote work
    Operations
    Full time
    Work at office
    Local area
    Monday to Friday

    HealthHelp - A WNS Company

    Houston, TX
    14 days ago
  •  ...System Department of UMHC SCCC Business Operations has an exciting opportunity for a full time Utilization Review Case Manager to work Remote. The incumbent conducts initial,...  ...concurrent and retrospective chart reviews for clinical utilization and authorization. The... 
    Remote work
    Operations
    Full time
    Work experience placement

    University of Miami

    United States
    12 hours ago
  •  ...or staff position, please review this tip sheet. The University...  ...of UMHC SCCC Business Operations has an exciting...  ...full time Utilization Review Case Manager to work Remote. The incumbent conducts initial...  ...retrospective chart reviews for clinical utilization and... 
    Remote work
    Operations
    Full time
    Temporary work
    Work experience placement
    Worldwide

    University of Miami

    Remote
    4 days ago
  • $63.1k - $94.65k

     ...is looking for a Utilization Review RN based in the United States....  ...financial integrity of hospital operations. In this part-time, remote role, you will apply your clinical expertise to evaluate medical...  ...and clinical indicators. Refer cases to physician advisors when necessary... 
    Remote work
    Operations
    Temporary work
    Part time
    Work at office
    Work from home
    Flexible hours
    Shift work
    Afternoon shift

    Jobgether

    Remote
    5 hours ago
  • $72k - $81k

     ...Case ManagerThe Case Manager manages an individual...  ...authorization of services, review of treatment plans for...  ...care team. This is a remote/work-from-home position...  ...Experience7 years of varied clinical experience preferred....  ...sufficient to operate standard office equipment... 
    Remote work
    Operations
    Temporary work
    Work at office
    Work from home
    Home office

    MedWatch LLC

    Lake Mary, FL
    1 day ago
  •  ...Position Summary: The RN Integrated Care Coordinator...  ...This role is critical to the operation of our Clinical Team and the overall experience...  ...to address utilization review cases. Roles and Responsibilities...  ...Requirements This is a remote position. Our whole company... 
    Remote work
    Operations
    Live in
    Flexible hours
    Weekday work

    Evry Healthcare Inc.

    Dallas, TX
    2 days ago
  • $80k - $120k

     ...Clinical Expert, Care Team Operations (RN) Remote Thesis is building the AI-powered care team platform for infinitely...  ...clinical operations workflows: Review prior authorizations, appeals, and...  ...agent capabilities, identifying edge cases, and providing feedback. We... 
    Remote work
    Operations

    Thesis Care, Inc.

    New York, NY
    4 days ago
  •  ...UnitedHealth Group is seeking a Preservice Review RN to work remotely in Hawaii. The role involves reviewing non-clinical and clinical documentation to support determinations...  ...allows remote work while handling complex cases. The role requires an Hawaii RN license, 3+... 
    Remote work

    Optum

    Honolulu, HI
    54 minutes ago
  • $78k - $85k

     ...re a people-focused, operations-driven organization...  ...hybrid role of nurse case management and utilization review. Position must be...  ...certified cases to peer clinical reviewers. Will...  ...and good standing RN license in the state...  ...or disability status. #LI-Remote #LI-AJ1
    Remote work
    Operations
    Full time
    Local area

    Intercare Holdings Insurance Services, Inc.

    United States
    4 days ago
  •  ...Case Manager RN The University of Miami UHealth Department of UMHC-SCCC Business Operations has an exciting opportunity for a full time Case Manager...  ...revisions to or new clinical pathways to improve quality...  ...of care regularly by chart review and patient interviews, as... 
    Remote job
    Operations
    Full time

    University of Miami

    Miami, FL
    3 days ago
  •  ...CVS Health is seeking a Clinical Claims Review Nurse to interpret clinical documentation...  ...with clinicians to resolve complex cases. The ideal candidate has RN licensure with 2–3 years of RN...  ...bachelor’s degree. This full-time, remote position is based in North Dakota... 
    Remote work
    Full time

    CVS Health Corporation

    North Dakota
    54 minutes ago
  • $42.36 - $61.5 per hour

     ...Cardiac Cath Lab RN Manager Clinical Operations & Team Leadership Company: HireNow...  ...assistance is considered on a case-by-case basis. A...  ...months. Eligibility will be reviewed before submission. Preferred...  ...permits. Roles advertised as remote within the U.S. also... 
    Remote work
    Operations
    Hourly pay
    Full time
    Relocation
    Relocation package

    Hirenow Staffing Inc

    Fort Lauderdale, FL
    5 days ago
  • $100k

     ...one of Danahers 15 operating companies our work saves...  ...possible. The Clinical Research Lab RN is responsible for...  ...supervisory role in the case of performing CPR....  ...contribute prepare and review study plans informed...  ...benefits of flexible remote working arrangements... 
    Remote work
    Operations
    Hourly pay
    Full time
    Work from home
    Flexible hours

    Danaher

    Irvine, CA
    2 days ago
  • $2,150 per week

     ...Revenue Cycle is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Fort...  ...and payers to ensure compliance with clinical guidelines, regulatory requirements,...  ...-based) ~ Skilled experience with remote work LENGTH OF ASSIGNMENT – 13... 
    Remote work
    Temporary work
    Zero hours contract
    Immediate start
    Shift work
    Night shift
    Weekend work

    AMN Healthcare Revenue Cycle

    Fort Myers, FL
    13 days ago
  • $27.5 - $44 per hour

     ...Senior Clinical Reimbursement Analyst - RN - Long Term Care Join to apply...  ...environment. Facility: Remote SD (Central Time)...  ...and support to all operating segments across Sanford. Responsible to review Medicare/Medicaid...  ...reflects categories for case mix/PDPM... 
    Remote work
    Operations
    Full time
    Part time
    Live in
    Work from home
    Shift work
    Day shift

    Good Samaritan

    South Dakota
    54 minutes ago
  • $29 - $52 per hour

     ...Connecting. Growing together. The Clinical Claim Review RN will be responsible for performing compliance...  ...audit workflow tools and the client's case tracking system. Where applicable, the...  ...your schedule. This position is Remote in Massachusetts. You will have the... 
    Remote work
    Hourly pay
    Minimum wage
    Full time
    Contract work
    Work experience placement
    Live in
    Local area
    Monday to Friday
    Shift work

    UnitedHealth Group

    Boston, MA
    4 days ago
  • $29 - $52 per hour

     ...Job Description - Preservice Review RN - Remote in HI (2392416) Preservice...  ...CPS_Conduct Non-Clinical Research to Support Determinations...  ...Determinations Determine that the case is assigned to the...  ...records, test results, prior operative reports) -Identify missing information... 
    Remote work
    Operations
    Hourly pay
    Minimum wage
    Full time
    Work experience placement
    Work at office
    Local area
    Monday to Friday

    Optum

    Honolulu, HI
    54 minutes ago
  • $37.45 - $57.29 per hour

     ...Registered Nurse (RN) is a professional...  ...Resource RN Become a Clinical Leader Across the...  ...'s clinical operations, supporting bedside...  ...Supervisors, charge nurses, case management, and...  ...If applying for a remote or hybrid role,...  ...assists in reviewing applications, all... 
    Remote work
    Operations
    Hourly pay
    Full time
    Shift work

    Intermountain Health

    Lafayette, CO
    54 minutes ago
  • $85k - $92k

     ...Equivalent: ~$41–$44/hr Location: Remote Schedule: Must work AZ hours (...  ...Active, unrestricted license: RN Minimum 3+ years clinical experience (med/surg and/or behavioral...  ...DESIRED) Clinical Quality / Utilization Review / Case Review experience Experience with... 
    Remote work
    Hourly pay
    Day shift

    TEEMA

    Phoenix, AZ
    5 days ago
  • $91.7k - $163.7k

     ...Coordination Manager, RN Optum is a...  ...flexibility to work remotely as you take on...  ...profession in the case management process...  ...to function as a clinical care team leader...  ...and LTSS program operations and service delivery...  ...electronic charting and review ~ Proficiency in... 
    Remote job
    Operations
    Minimum wage
    Full time
    Work experience placement
    Local area

    divvyDOSE

    El Paso, TX
    14 hours ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Remote RN - Clinical Case Review & Operations (256033). Be the first to apply!