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$50 per hour
...RN Clinical Reviewer / IDR - Remote to Office-Based Setting - Jericho, NY (\#25309) Location: Hybrid (Remote to Office-Based) - Jericho, NY... ...reviews up to and including the appeal level. This includes chart screen, compiling regulatory guidance, researching...Remote workHourly payFull timePrivate practiceWork at officeFlexible hoursGreenLife Healthcare Staffing
Jericho, NY3 days ago- ...physicians looking for additional income as a collaborating physician (Chart Reviews). Our collaborators over see our highly skilled Nurse... ...Type: Collaborating Physician - 1099 (Chart Reviews) Location: Remote Opportunity - State of Missouri Hours: Flexible Hours...Remote workExtra incomeFull timeFor contractorsReliefFlexible hours
Matrix Medical Netowrk
Scottsdale, AZ2 days ago $62.7k - $100.4k
...outcomes and lower costs of care. Job Summary: Clinical Care Reviewer II is responsible for processing medical necessity reviews for... ...Science (A.S) Completion of an accredited registered nursing (RN) degree program required Three (3) years clinical experience...Remote workHourly payWork at officeCareSource
Boston, MA6 days ago- ...hospital case management/utilization review and discharge planning... ...: Colleague must have an RN license, as defined by their primary... ...Hybrid position. Onsite and remote work to be determined by the... ...individual patients in Power Chart. Actively participates in department...Remote workFull timeLocal areaShift workDay shift
Trinity Health
Boise, ID13 hours ago $89.07k - $162.8k
...admission concurrent and retrospective case reviews to ensure appropriate admit status and... ...UR experience required. Must live in area. Remote after completion of on-site orientation. *... ...preferred Licenses and Certifications RN - Registered Nurse - State Licensure and/...Remote workLive inMedStar Health
Clinton, MD3 days ago- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent... ...the progression of care process. Conducts chart audits and performs peer-to-peer evaluations...SuggestedPermanent employmentWork at officeLocal area
Houston Methodist Hospital
Houston, TX13 hours ago - A healthcare solutions company is seeking a Clinical Reviewer - LPN/LVN or RN for a remote role in the U.S. Responsibilities include reviewing medical records and ensuring accuracy in adherence to criteria. Candidates must possess an active license, with 2+ years of experience...Remote jobShift work
- Essential Duties and Responsibilities: - Review requests for services including admission,... ...An active unrestricted Registered Nurse (RN) or Licensed Practical Nurse (LPN) license... ...secure workspace #ClinicalServices #LI-Remote EEO Statement Maximus is an equal...Remote workMinimum wageContract workTemporary workWork experience placementWork at officeHome office
MAXIMUS
United States4 days ago - A healthcare solutions provider is seeking a Clinical Reviewer - LPN/LVN or RN - PRN (remote U.S.) to utilize clinical expertise in reviewing medical records against criteria. Candidates must have an active Indiana license or compact license. This role is flexible, with...Remote jobReliefFlexible hours
- ...RN / Medical Reviewer / Remote Job Details Professional Discipline : Registered Nurse Specialty : Utilization Review Employment Type : Full Time City : Columbia State : SC Pay Range : Job Description...Remote workFull timeContract workLocal areaShift work
InGenesis
United States2 days ago - ...recruiting for a HEDIS Clinical Review Nurse, LVN for a Public Health... ...Supervisor and HEDIS Nurse RN with compliance with DHCS, CMS... ...on a hybrid schedule (2 days remote, 3 office). This will start out... ...specifications when performing chart reviews and communicate changes...Remote workPermanent employmentTemporary workWork at office
Kinetic Personnel Group, Inc
Ontario, CA3 days ago $28 - $32 per hour
...Job Summary and Responsibilities Acentra seeks a Clinical Reviewer to join our growing team. Job Summary: The purpose of... ...Required Qualifications/Experience: Active unrestricted RN or, or other applicable State and/or Compact State clinical license...Remote workContract workLocal areaFlexible hoursShift workAcentra Health
McLean, VA9 days ago- A leading managed care organization is seeking a self-motivated RN for a fully remote Utilization Review Nurse position. Responsibilities include assessing member needs, ensuring medical necessity of services, and collaborating with healthcare professionals. Candidates...Remote job
$90k - $99k
...leading healthcare technology firm is seeking a DRG Nurse Reviewer Appeals and Hearings to work remotely. The role involves reviewing provider appeals and... ...preparations for hearings. Applicants must hold an active RN license and relevant coding certifications with a strong...Remote jobFlexible hours$38.46 - $48 per hour
...innovation. Job Summary The Clinical Review Nurse evaluates medical records and... ...secure handling of PHI in all systems and remote work environments. • Other duties as... ...school of nursing • Active, unrestricted RN or LVN/LPN license • Must hold a current...Remote workHourly payWork at officeClever Care Health Plan
Huntington Beach, CA13 hours ago- A healthcare consulting company is seeking a remote Dietitian to conduct quality reviews for the U.S. Department of Veterans Affairs. The role involves evaluating clinical cases and producing structured assessments. Candidates must have an RDN credential and at least 3...Remote jobFull timeFlexible hours
- ...contribute to a system that values bold ideas and community-centered care. The Utilization Review Nurse RN conducts initial, concurrent and retrospective chart review for clinical, financial and resource utilization information. Provides intervention and...Shift workWeekend work
LifeBridge Health
Randallstown, MD2 days ago $27.02 - $48.55 per hour
...Position Purpose: Performs concurrent reviews, including determining member's overall health... ...: For Health Net of California: RN license required ** Must be licensed in California Location: Position is remote. Hours: 8:00-5:00 PST. Pay Range: $27...Remote workHourly payFull timePart timeWork at officeFlexible hoursCentene Corporation
Sacramento, CA3 days ago$45.9 - $71.4 per hour
...Description Utilization Review RN - Remote Providence Health Plan caregivers are not simply valued - they're invaluable. Join our team at Providence Health Plan Partners and thrive in our culture of patient-focused, whole-person care built on understanding,...Remote workMinimum wageFull timeLocal areaShift workProvidence Health & Service
Portland, OR4 days ago- ...DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are... ...of relevant education and experience. • Registered Nurse (RN). License must be active and unrestricted in state of practice....Remote workWork at office
Molina Healthcare
United States1 day ago - ...Job Role: Nurse Abstractor Remote 99% (occasional in-person attendance required) Part... ...Overview The Suicide Mortality Review (SMR) Program, within the Arizona Department... ...: Registered Nurse Clinical Licensure (RN, LPC, APRN) Bachelor's Degree in Nursing...Remote workPart timeWork at officeFlexible hoursAfternoon shift
Compu-Vision Consulting
Phoenix, AZ3 days ago $40 per hour
...Clinical Support Manager (temporary) to oversee workflow and process improvements remotely. This role requires strong clinical knowledge in acute care settings and experience with utilization review. Candidates should possess excellent communication skills and the ability to...Remote jobHourly payTemporary work- ...JOB DESCRIPTION: The Registry Utilization Review Nurse (PRN) is responsible for conducting... ...conjunction with a review of the patient chart, clinical nursing judgement, and discussions... ...physician and/or physician advisor. The UR RN (PRN) will perform utilization review by...Temporary workCasual workReliefShift work
Emory Healthcare
Atlanta, GA4 days ago - Explore the Possibilities and Advance with Us. Nurse Reviewer - REMOTE Job Number : 2025-47793 Category: Nursing Location : Shrewsbury, MA Shift... .... Perform other duties as required. REQUIRED QUALIFICATIONS: RN/OT/SW licensed to practice in the Commonwealth of...Remote jobFull timeShift work
- ...Medical, Dental, Vision and Life Insurance. Position: Utilization Review Nurse - Case Management Compensation: The estimated pay... ...Medical Center. Incumbents perform clinically oriented medical chart reviews and other administrative tasks to meet the requirements...Work at officeLocal area
Kern Medical
Bakersfield, CA3 days ago - ...Medical Claims Reviewer Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable... ...combination of relevant education and experience. Registered Nurse (RN). License must be active and unrestricted in state of practice....Remote workWork at office
Molina Healthcare
Albuquerque, NM2 days ago - A major healthcare organization is seeking a registered nurse for a remote position focused on utilization review. Candidates should have 2 years of experience in a hospital setting and expertise in evaluating medical necessity. Responsibilities include assessing care levels...Remote job
- ...Job Title: Care Review Clinician I | Utilization Review Nurse Location: Fully Remote Duration: 03+ months (possible extension) Schedule: After 6 weeks of training/onboarding... ...). Licensure: Active, unrestricted Nevada RN license (required upon hire or within 90 days). Experience...Remote workLive inWork at office
Careers Integrated Resources Inc
Atlanta, GA3 days ago - ...Rancho Cordova, CA. This role involves conducting utilization reviews and ensuring compliance with medical guidelines. Ideal candidates... ...environment. The position offers a hybrid work model, blending remote and on-site responsibilities. Strong communication skills and...Remote work
- A regional healthcare provider in Houston is seeking a Utilization Management Review Nurse. This role involves evaluating the appropriateness of medical services based on necessity and promoting quality care outcomes. The candidate must have a Bachelor's in Nursing and...Remote jobFlexible hours
