Remote Clinical Review Nurse - Concurrent Review
Spectraforce Technologies
Spectraforce Technologies is seeking a Clinical Review Nurse for concurrent review. This remote role supports US-based operations, requiring a nursing credential and at least 1 year of nursing experience. The position emphasizes denial review, NCQA standards, and coordinated communication with agencies and teams. The candidate will draft letters, investigate denials, and help train teams to improve utilization management processes. #J-18808-Ljbffr
$27.02 - $48.55 per hour
...This position is fully remote/work from home;... ...applicants with strong clinical background, managed care... ...utilization management/review experience are helpful... ...Position Purpose: Performs concurrent reviews, including... ...Accredited School of Nursing or Bachelor’s degree in...Remote workHourly payFull timePart timeWork at officeWork from homeMonday to FridayFlexible hours- ...Job Title: Clinical Review Nurse - Concurrent Review Location: Remote -Anywhere in US Shift : Tuesday - Thursday 9:30 am - 6 pm CST / Overtime may be required and Holidays are required Duration : 12 months Position Purpose: Drafts correspondence letters based on review...Remote workLocal areaShift work
- ...Position Title : Clinical Review Nurse - Concurrent Review Work Location : Remote (Compact Nursing License Required, Central Time Zone) Assignment Duration : 12 months (Possibility to extend or convert) Work Schedule : Friday-Tues, 2 pm-10 pm CST, 40 hours/week. Either...Remote workShift workWeekend work
$27.02 - $48.55 per hour
...About This Role The Clinical Review Nurse performs concurrent reviews to determine members' overall health, evaluate medical necessity, and contribute... ...processes. Highlights Pay: $27.02 - $48.55 per hour Location: Remote, NY Schedule: Full-time, Monday-Friday, 8:30 AM to 5:00...Remote workHourly payFull timeMonday to FridayFlexible hours- A healthcare organization is seeking a Clinical Review Nurse - Concurrent Review to perform utilization management functions remotely. The role requires conducting concurrent reviews, collaborating with medical teams, and ensuring quality healthcare outcomes. Candidates...Remote workWork at office
- Centene Corporation is seeking a Remote RN in Missouri with an active MO license and 8-hour workdays. The role focuses on concurrent reviews, evaluating medical necessity, and discharge... .... Ideal candidates have strong clinical background and experience in managed care...Remote jobMonday to Friday
- Centene is seeking a Clinical Review Nurse to perform concurrent reviews of members to determine overall health, evaluate medical necessity, and contribute... ...of utilization management processes. The position is remote with NY location indicators and offers a full-time...Remote jobFull time
- ...Elevance Health’s Wellpoint Federal division seeks a Clinical Review Nurse I to assess pre-claim reviews and claims for medical necessity and eligibility. This remote role emphasizes accuracy, policy knowledge, and timely decision-making. The position requires an AS in...Remote work
- ...Position Title: Clinical Review Nurse - Prior Authorization Assignment Duration: 6 months; potential to extend/convert Work Schedule:... ...CST Mon - Fri / Possible holiday shifts Work Arrangement: Remote-Central Time Zone preferred Responsibilities:...Remote workShift work
- ...Clinical Medical Review Nurse We are seeking Licensed Practical Nurses (LPN) or Registered Nurses (RN) to join the Quality team as Clinical Medical... ...Nurses. This is a hybrid contract position requiring both remote work and regular onsite presence at the Canton, MD office....Remote workContract workWork at office2 days per week3 days per week
$44 per hour
...Clinical Review Nurse - Prior Authorization Various, NV Clinical Review Nurse - Prior Authorization Various, NV All On-site Location: Fully Remote – Prefer Candidates reside in NV, but can reside elsewhere if they have an NV RN License. SHIFT: Training...Remote workPermanent employmentContract workLive inShift work- ...Concurrent Review Registered Nurse (RN)Location: Fully remote. Candidates must be able to work a schedule aligned with Pacific Time (PST) business hours.Our client... ...management teams.Request and review additional clinical documentation when necessary.Escalate complex...Remote workWork at officeImmediate start
- ...CLINICAL REVIEW NURSE - REMOTE ARC Group has multiple positions open for Clinical Review Nurses! These positions are 100% remote. These are direct hire FTE positions with salary, benefits, etc. This is a fantastic opportunity to join a dynamic and well-respected...Remote workPermanent employmentWork at officeLocal area
$73k - $82k
...Shield of Vermont is looking for a Clinical Review Registered Nurse to join our Utilization Management team... ...the office with flexibility to work remotely the rest of the week. We are only... ...Conduct clinical reviews for preservice, concurrent, and retrospective authorizations...Remote workWork at officeFlexible hours$34 - $40 per hour
...Job Title: Clinical Review Nurse (Remote) Position Summary: We are seeking a detail-oriented and clinically skilled Clinical Review Nurse to join our team in a fully remote role. The Clinical Review Nurse is responsible for conducting medical necessity reviews, evaluating...Remote workContract workTemporary work- ...Clinical Medical Review Nurse Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are... ...team with professionalism and a collaborative mindset. Remote work environment with minimal physical demands. Ampcus...Remote work
- ...re looking for US-credentialed clinical professionals to support a... ...use your clinical expertise to review and interpret de-identified electronic... ...US-credentialed Registered Nurse (RN), Nurse Practitioner (NP),... ...working independently in a remote environment. Strong written communication...Remote jobFor contractors
$34 - $40 per hour
...Clinical Review Nurse (Remote) We are seeking a detail-oriented and clinically skilled Clinical Review Nurse to join our team in a fully remote role. The Clinical Review Nurse is responsible for conducting medical necessity reviews, evaluating clinical documentation,...Remote jobContract workTemporary work$85k - $92k
Job Title: CLINICAL QUALITY REVIEWER (RN or LCSW) Location: USA- Remote in approved states Overview TEEMA is partnering with a leading organization supporting a... ...have Active, unrestricted license as a Registered Nurse (RN) or Licensed Clinical Social Worker (LCSW)...Remote workHourly payWork at officeHome office$75k
...Description • Performs concurrent inpatient utilization review using InterQual criteria... ...care reviews (Skilled Nursing Facility, Inpatient Rehabilitation... ...updates • Engage in clinical collaboration with... ...August Location: 100% remote Equipment: Provided (mini...Remote workFor contractorsWork at officeLocal areaMonday to FridayFlexible hoursWeekend work$100 per hour
## Physician, Concurrent Inpatient Review (PT Evenings/Weekends) (Remote) (Hospital Advocacy)Applylocations: US - Remotetime type: Part timeposted on: Posted Todayjob... ...reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling...Remote jobHourly payWork at officeImmediate startWork from homeMonday to FridayWeekend workAfternoon shift$20 - $36 per hour
...Utilization Review Lvn Nurse Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a...Remote jobHourly payMinimum wageFull timeWork experience placementWork at officeLocal area$69.3k - $78k
...healthcare payment integrity company is seeking a Medical Review Nurse II - Clinical Validation to perform medical claims audits for Government... ...include auditing claims and documenting findings, all in a remote work environment. This role offers a competitive salary range...Remote job- Brighton Health Plan Solutions is seeking an Utilization Management Nurse to perform medical necessity and benefit reviews remotely. The role requires current LPN licensure and expertise in CMS/MCG criteria with experience in inpatient/outpatient reviews. The successful...Remote job
$69.3k - $78k
Overview Medical Review Nurse II - Clinical Validation At Performant, we’re focused on helping our clients achieve their goals by providing technology... ...for Government and Commercial Payers. You will work remotely in a fast paced and dynamic environment and be part of a...Remote workFor contractorsWork at officeWork from homeHome officeShift work- ...Providing support for inpatient and outpatient clinical claim review activities, the full-time Remote Registered Nurse Clinical Reviewer will verify coded diagnoses, procedures, and revenue codes to ensure accuracy and compliance with billing guidelines while assessing...Remote workFull time
- Centene Corporation is hiring a Manager of Clinical Review for a remote leadership role in healthcare integrity. You will lead clinical investigators... ...role requires a strong clinical background with coding, nursing experience, and team management skills. Pay range and...Remote job
$65 - $95 per hour
...Time Consulting Opportunity for Nursing Professionals We are sharing... ...professionals experienced in patient care, clinical monitoring, medication... ...structured healthcare workflow review. This role supports current and upcoming remote consulting opportunities focused...Remote jobHourly payWeekly payContract workPart timeFor contractorsFlexible hours$78k - $88k
...Utilization Review Nurse- Remote It takes great medical minds to create powerful solutions that... ...prior authorization, prospective, concurrent, and retrospective reviews for medical... ...appropriateness of services, following clinical criteria, coverage policies, and contract...Remote workFull timeContract workWork at officeWork from homeFlexible hours- ...Job Description: Manager of Clinical Utilization Management - Denial... ...CAPosition Type: Hybrid (85% remote, 15% onsite in Northridge, CA... ...daily tasks, performance reviews, and any necessary disciplinary... ...from an accredited Registered Nursing Program; RN preferred.2. Minimum...Remote workPermanent employmentFull timeTemporary workFlexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote Clinical Review Nurse - Concurrent Review. Be the first to apply!
- clinical nurse Raleigh, NC
- nurse practitioner ii Raleigh, NC
- telemedicine women's health nurse practitioner Raleigh, NC
- nurse practitioner urology Raleigh, NC
- clinical research nurse Raleigh, NC
- work from home nurse practitioner Raleigh, NC
- nurse manager Raleigh, NC
- telemedicine nurse practitioner Raleigh, NC
- director of nursing rn Raleigh, NC
- nurse supervisor Raleigh, NC

