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- ...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, AZ2 days ago - ...healthcare organization is hiring a Registered Nurse/Medicaid Clinical Reviewer for a fully remote position. This role requires strong... ...compliance with state laws. Candidates should possess an active RN State license, relevant experience in case review, and proficiency...SuggestedRemote work
GreenLife Healthcare Staffing
New York, NY7 hours agonew - ...opportunities with the University of Mississippi Medical Center. Please review the following instructions prior to submitting your job... ...Review Location/s: Main Campus Jackson Job Title: RN - Utilization Reviewer - Coordinated Care - PT - Remote Job Summary...SuggestedPart timeWork experience placementCasual workSeasonal workRemote workShift work
University of Mississippi Medical Center
United States3 days 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, NY3 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, GA4 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, NY12 hours 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, TX1 day ago - A nonprofit healthcare organization is hiring a Surgical Clinical Reviewer to evaluate surgical data and charts. Applicants should possess a nursing background and 2-5 years of relevant experience. The role requires strong attention to detail and effective collaboration...Suggested
- A healthcare organization in Fort Worth, TX seeks a UM/ECM - RN Reviewer to coordinate health care resources for members. This role involves assessing clinical information, working with providers and ensuring quality care within the healthcare system. Candidates should...SuggestedFull time
- 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 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...SuggestedWork experience placementFlexible hoursVNS Health
New York, NY12 hours ago- A healthcare review organization is looking for experienced Registered Nurses (RNs), Nurse Practitioners (NPs), or Practicing Assistants... ...in scheduling and is fully remote. Candidates must have an active RN, NP, or PA license and prior experience in disability reviews. The...SuggestedRemote jobReliefFlexible hours
- ...Brooklyn is looking for a Registered Nurse to join as a Quality Reviewer. This full-time position requires ensuring the accuracy of documentation... ...with CMS standards. Candidates should possess a New York State RN License and documentation skills. The role offers comprehensive...SuggestedFull time
- A healthcare organization in Wyoming is seeking a Quality Nurse Reviewer to ensure compliance and survey readiness for various regulatory agencies. Responsibilities include conducting medical record reviews and assisting in quality improvement initiatives. The ideal candidate...Suggested
- A healthcare solutions organization in Atlanta is seeking a Review Nurse for its Prior Authorization & Utilization Management team. The ideal candidate must be a Registered Nurse with a valid Georgia nursing license and at least three years of clinical experience. Responsibilities...
- ...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...Contract workWork at office
- A healthcare provider in Boise is seeking a Clinical Documentation Specialist - RN to enhance clinical documentation and coding processes. Responsibilities include reviewing clinical documentation, ensuring compliance with regulations, and collaborating with staff for accurate...
- ...Utilization Review RN/Documentation Specialist - (Full-Time) At OSS Health, our mission is to continually strive to be the healthcare leader in quality, innovation and value. We make every effort to understand and exceed the expectations and needs of our patients. We...Full timeWork experience placementWork at officeLocal areaImmediate startNight shift
$63 - $70 per hour
Medasource is seeking a local contract nurse RN Clinical Document Improvement Specialist for a local contract nursing job in Modesto,... ...: Clinical Document Improvement Specialist (RN) - Quality / Peer Review Location: Modesto, CA Contract Length: 13 Weeks Schedule: Day Shift...Hourly payWeekly payContract workLocal areaRelocationShift workDay shiftMedasource
Modesto, CA4 days ago$53 - $58 per hour
Talent4Health is seeking a local contract nurse RN Clinical Document Improvement Specialist for a local contract nursing job in Chicago, Illinois. Job Description & Requirements Specialty: Clinical Document Improvement Specialist Discipline: RN Start Date: 04/27/2026 Duration...Hourly payContract workSecond jobLocal areaShift workWeekend workDay shiftTalent4Health
Schiller Park, IL2 days ago$2,622 per week
Care Team Solutions is seeking a travel nurse RN Clinical Document Improvement Specialist for a travel nursing job in Rochester, Minnesota. Job Description & Requirements Specialty: Clinical Document Improvement Specialist Discipline: RN Start Date: 04/20/2026 Duration...Weekly payContract workShift workDay shiftCare Team Solutions
Rochester, MN12 hours ago$2,725 per week
Talent4Health is seeking a travel nurse RN Clinical Document Improvement Specialist for a travel nursing job in Chicago, Illinois. Job Description & Requirements Specialty: Clinical Document Improvement Specialist Discipline: RN Duration: 12 weeks 40 hours per week Shift...Second jobLocal areaShift workWeekend workDay shiftTalent4Health
Schiller Park, IL2 days ago- A global health organization is seeking professionals for clinical case reviews involving claims assessment based in San Juan, Puerto Rico. Candidates must hold a valid Puerto Rico RN Nursing Licensure or relevant coding certifications and have at least one year of experience...
$150 per hour
...Registered Nurse / Wound Care (Tier 3) / VA Reviewer - Remote (#25276) Location: Remote Employment Type: Contract (Case-based... ...program. Licensure: Must hold a current, non-restricted RN license in a U.S. state or territory. Experience: Minimum of...Hourly payPrice workExtra incomeContract workPrivate practiceWork at officeRemote workFlexible hoursGreenLife Healthcare Staffing
Myrtle Point, OR2 days ago$54 - $57 per hour
PRN Healthcare is seeking a local contract nurse RN Clinical Document Improvement Specialist for a local contract nursing job in Chicago, Illinois. Job Description & Requirements Specialty: Clinical Document Improvement Specialist Discipline: RN Start Date: 04/20/20...Hourly payWeekly payDaily paidContract workLocumReliefLocal areaShift work$2,800 per week
...Registered Health Information Administrator (RHIA) Registered Nurse (RN) Registered Respiratory Therapist (RRT) Certified Coding... ...Clinical Documentation Integrity (ICDI) Specialist is accountable for reviewing patient medical records in the inpatient and/or outpatient...Remote workMonday to FridayFlexible hoursAfternoon shiftMayo Clinic - 200 1st St SW
Rochester, MN12 hours ago- ...and quality of care. Duties & Responsibilities Provides timely review of SOC, ROC and Recertification documentation. Utilizes CRC assessment... ...in OASIS review and ICD-10 coding. Qualifications Current NJ RN or PT license. Three years of certified home care experience....Hourly payFull timeTemporary workPart timeFor contractorsFor subcontractorFlexible hours
$3,344 per week
Vivian is looking for Travel Clinical Document Improvement Specialist RNs in Chicago, Illinois paying up to $3,344/week At Vivian, we ensure your next step is a step forward. That's why we built a jobs marketplace that serves healthcare professionals first. It's easy...Full timeShift workVivian Health
Chicago, IL2 days ago- ...evaluation, and certification to ensure build-related products, systems, and materials are safe and compliant. This includes plan review, inspection, and HUD services. Position Summary: Provide plan review services in accordance with the modular State program or the Local...Temporary workWork at officeLocal areaImmediate startWorldwideFlexible hours
ICC NTA LLC
Nappanee, IN2 days ago
