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- ...RN Quality Assurance Reviewer Essential Healthcare Solutions is looking for a detail-oriented, problem-solving team player ready to take on a meaningful role in ensuring high-quality care for patients and residents in healthcare facilities nationwide. This position...SuggestedLocal areaFlexible hours
Essential HealthCare Solutions, LLC
Houston, TX1 day ago - ...Job Description: The Position: Quality Reviewer RN Schedule: Monday - Friday 8:30 AM - 5:00 PM The Quality Reviewer is a Registered Professional Nurse who will ensure the accuracy, completeness and integrity of documentation completed by the COC.. This individual...SuggestedWork at officeLocal areaMonday to Friday
Americare
New York, NY2 days ago $52 per hour
...Job Title: Health Service Reviewers (RN) Pay (openings for each location/market): Albany up to $52/hr Central Islip up to $60/hr Overview: These RNs will be doing a mix of standard quality audits, complaint initiated investigations, and more...SuggestedWork at officeLocal areaMonday to FridayMedix
Central Islip, NY3 days ago$39.32 - $48.06 per hour
...Ready to help us transform healthcare? Bring your true colors to blue. The Role The RN Utilization Management Reviewer is responsible for facilitating care for members who may have complex healthcare needs, authorizing medically necessary services at the right level...SuggestedHourly payWork at officeRemote workFlexible hoursShift workBlue Cross Blue Shield of Massachusetts
Hingham, MA2 days ago- ...RN experienced with OASIS and certified ICD 10 Reviewer - HOME HEALTH SERVICES Must have ICD-10 Certification and live in Atlanta, GA Join the PruittHealth @Home family, where we deliver quality care where the patients choose to be! We know that home is where the...SuggestedLive inFlexible hours
PruittHealth
Norcross, GA2 days ago - ...Join a dedicated healthcare team in the Midwest region as an Advanced Cardiac Cath Lab RN Reviewer focused on quality assurance. This role involves meticulous collection and submission of clinical data to national registries, ensuring accuracy and compliance in both inpatient...SuggestedWork at office
MLee Medical Employment
Koeltztown, MO3 days ago $115k
...Perinatal Revewer can work anywhere in the United States. Perinatal Reviewer, with minimal immediate direction or supervision, survey and/or... ...andfunctionality of care delivery systems. Perinatal RN Reviewermust have the credentials, presence and expertise to earn...SuggestedFor contractorsCurrently hiringImmediate startThe Joint Commission
Villa Park, IL4 days ago- ...provision of quality care throughout the continuum of care. The Registered Nurse Utilization Management/Episodic Case Manager (UM/ECM - RN) Reviewer facilitates clinically appropriate and fiscally responsible care through communication with the providers and health plan...SuggestedShift workDay shift
Cook Children's Health Care System
Fort Worth, TX4 days ago - ...POSITION SUMMARY: The Prior Authorization RN is responsible for reviewing and processing medical prior authorization requests to ensure services are medically necessary, meet evidence-based guidelines, and align with the health plan’s policies. This RN plays a critical...Suggested
Medasource
Phoenix, AZ1 day ago - ...accreditation entities. Refers appropriate cases to the Medical Director for review. Refer to and work closely with Case Management to address member... ...opportunities. All Levels Associates degree and active NYS RN license required. Bachelors degree preferred. Minimum of three (3...SuggestedContract workWork at officeRemote work
- A leading pediatric healthcare organization is seeking a Utilization RN II responsible for managing medical necessity for inpatient admissions. The role demands expertise in utilization management and collaboration with healthcare providers. Candidates should have at least...SuggestedRemote job
- ...leading healthcare solutions provider is seeking a Clinical Care Reviewer to evaluate medical necessity for inpatient and outpatient... ...or BSN, a minimum of 3 years of clinical experience, and a valid RN license in the District of Columbia. The position offers a competitive...SuggestedRemote job
- A healthcare service provider in New York is seeking a Pediatric Quality Reviewer RN to ensure accurate documentation for OASIS assessments. This full-time role, operating Monday to Friday, offers comprehensive benefits including medical, dental, and vision insurance, along...SuggestedFull timeMonday to Friday
- A healthcare provider in Columbia, SC is seeking an experienced RN OASIS and ICD 10 Reviewer to join their Home Health Services team. The ideal candidate must have active RN licensure and ICD-10 certification, showcasing experience with OASIS documentation. This role involves...Suggested
- A leading home health provider is seeking a Registered Nurse RN OASIS and ICD 10 Reviewer in Norcross, Georgia. The role involves conducting assessments and maintaining patient care within home environments. Ideal candidates will have ICD-10 Certification and an active...SuggestedFlexible hours
$93.4k - $116.8k
...Overview Are you an experienced RN with a strong background in Quality including quality of care reviews, incident investigation, and regulatory compliance? VNS Health Plans is seeking a seasoned clinical professional to play a critical role in reviewing and resolving...Work experience placementFlexible hoursVNS Health
New York, NY3 days ago$1,225 per week
...GHR Healthcare - Travel is seeking a travel nurse RN Clinical Document Improvement Specialist for a travel nursing job in Philadelphia... ...— Part-time/PRN inpatient role supporting documentation reviews and quality improvement for Philadelphia, PA (19107). Ideal for...Weekly payPart timeReliefRemote workFlexible hoursShift workGHR Healthcare
Philadelphia, PA6 hours agonew$2,468 per week
Job Description & Requirements LanceSoft is seeking a travel nurse RN Clinical Document Improvement Specialist for a travel nursing job in Tarzana, California. Specialty: Clinical Document Improvement Specialist Discipline: RN Start Date: 05/04/2026 Duration: 13 weeks...Weekly payShift work$28 - $31 per hour
...monitoring, as needed to support nursing staff or in emergencies. Assess residents' conditions, report changes to the Registered Nurse (RN) or physician, and document observations accurately. Collaborate with the interdisciplinary team to develop and implement...Hourly payFull timeImmediate startShift workNight shiftLarry H. Miller Senior Health
Pepper Pike, OH1 day ago$29.29 - $50.38 per hour
...the Licensed Practitioner of the Healing Arts (LPHA) authorizing Integrated Assessment and Treatment Plans. Will complete thorough review of each document, provide clinical guidance to team members, and ensure compliance with IATP standards. LPHA reviewer provides behavioral...Full timeLocal areaImmediate startRelocationRelocation packageShift work- ...comprehensive, competitive, and generous providing room for potential growth and position/compensation advancement. SUMMARY: Review tax information provided by network of abstractors for accuracy and completeness. Prepare and deliver certifications to customer...Work at office
SummitHR
Pittsburgh, PAa month ago - ...Excellent Non-Clinical Work Opportunity for Hygienists! We have contracted with a major dental insurance provider to perform site reviews at participating dental practices The job consists of traveling to dental office and working through a checklist for a visual...Casual workWork at office
MRINetwork
Pompano Beach, FL1 day ago $95k - $120.65k
...division, this role is responsible for conducting post-service, pre-payment and post pay comprehensive inpatient DRG Quality Assurance reviews in an effort to increase the savings achieved for Zelis clients. Conduct reviews on inpatient DRG claims as they compare with...Full timeWork at officeLocal areaRemote workVisa sponsorshipFlexible hoursZelis Healthcare
Plano, TX2 days ago- ...Position Title: HEDIS Data Reviewer Location: Philadelphia, PA 19113 (Hybrid) Duration: 3 Months Schedule: Standard 8 am -5:30 pm EST Summary: Under the direction of the Manager of Medical Record Review Operations, the HEDIS Data...Work at office
Pacer Staffing
Philadelphia, PA7 days ago - ...HJ Staffing is seeking a highly detail-oriented HEDIS Data Reviewer to join our team in support of our client . Working under the direction... .../well-care terminology). Education: Associate's Degree, RN, LPN, or equivalent relevant work experience. Software:...Work experience placementWork at officeRemote workMonday to Friday
HJ Staffing
United States13 days ago $115k
...Responsibilities # Conducts a thorough evaluation of assigned services and programs that meet DSC certification eligibility criteria. Plans, reviews and apportions review time so that all review requirements are addressed thoroughly per program. Reviews and evaluates pre-review...For contractorsCurrently hiringWork at officeThe Joint Commission
Villa Park, IL4 days ago- ...products, including iPhone, iPad, Mac, Apple Watch, and Apple TV. From consulting on both hardware and software, auditing code and reviewing designs, the job is as diverse as it is critical. This position requires someone with strong technical abilities and a passionate...
Apple
Cupertino, CA3 days ago $28 per hour
...CONTRACT REVIEWER Camden, NJ Job ID 59546 Job Type Full Time Shift Day Specialty Other Professional Apply About us At Cooper University Health Care , our commitment to providing extraordinary health care begins with our...Hourly payFull timeContract workPart timeShift workCooper University Health Care
Camden, NJ4 days ago- ...you are interested in being part of a winning team, Legacy PSG, Inc. is the perfect place to start! Summary/Objective Title Reviewers are responsible for reviewing the work of title abstractors. Responsible for reviewing all Limited Title Certificates and title...Work at office
Legacy PSG, Inc.
Lubbock, TX2 days ago $34 - $44.82 per hour
...The Fountain Group is currently seeking a Quality Control Data Reviewer for a prominent client of ours. This position is located in Philadelphia, PA. Details for the position are as follows: ~ Pay: $34-44.82/hr. ~12-month assignment with possibility for extension...The Fountain Group
Philadelphia, PA2 days ago
