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Contract Rn Case Review Jobs (NOW HIRING)

Trinity Health

RN Case Manager

Nashville, TN · On-site

$1.86K/wk

Minimum 1 year License: RN License required Certifications: [Specify any required certifications ... Participate in interdisciplinary team meetings and case reviews. Client Details Address 4220 ...

Prime Staffing

Travel RN Case Manager

Santa Rosa, CA

Strong assessment, discharge planning, and utilization review skills Description: The RN Case ... contracts to our workforce. Our experienced team takes the time to get to know both our clients and ...

Prime Staffing

Travel RN Case Manager

Bel Air, MD

Strong assessment, discharge planning, and utilization review skills Description: The RN Case ... contracts to our workforce. Our experienced team takes the time to get to know both our clients and ...

Prime Staffing

Travel RN Case Manager

Bel Air, MD · On-site

Strong assessment, discharge planning, and utilization review skills Description: The RN Case ... contracts to our workforce. Our experienced team takes the time to get to know both our clients and ...

RN

Registered Nurse, Case Manager

Rome, NY · On-site

$75.25K - $87.14K/yr

As we continue to expand our clinical programs to meet increasing community needs, we are seeking RN Case Managers to join our teams in Onondaga, Oneida, Oswego, Jefferson, or Cayuga Counties! If you ...

RN

Registered Nurse, Case Manager

Auburn, NY

$75.25K - $87.14K/yr

Homecare RN Delivering Personalized Clinical Excellence in the Comfort of the Patient's Home! As we continue to expand our clinical programs to meet increasing community needs, we are seeking RN Case ...

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How much do contract rn case review jobs pay per hour?

As of May 30, 2026, the average hourly pay for contract rn case review in the United States is $47.53, according to ZipRecruiter salary data. Most workers in this role earn between $35.34 and $57.45 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Contract RN Case Review, and why are they important?

To thrive as a Contract RN Case Review, you need a valid RN license, strong clinical judgment, and experience in case management or utilization review. Familiarity with medical coding systems (such as ICD-10, CPT), case management software, and knowledge of regulatory guidelines like Medicare and Medicaid are typically required. Excellent analytical thinking, attention to detail, and effective communication skills are crucial soft skills for this role. These competencies ensure accurate case assessments, compliance with healthcare regulations, and effective collaboration with providers and payers.

How does a Contract RN Case Review professional typically collaborate with other healthcare team members?

As a Contract RN Case Review professional, you'll frequently coordinate with physicians, social workers, and other nursing staff to ensure comprehensive patient care. Collaboration often involves reviewing patient charts, discussing care plans, and providing recommendations for discharge planning or ongoing management. Effective communication is key, as you'll need to relay findings and updates to both internal teams and external case managers. This role often requires balancing independent, detailed review work with regular interdisciplinary meetings to drive optimal outcomes for patients.

What is a Contract RN Case Review nurse?

A Contract RN Case Review nurse is a registered nurse who is hired on a contractual basis to evaluate patient cases, often for insurance companies, hospitals, or healthcare organizations. Their main duties include reviewing medical records, ensuring compliance with clinical guidelines, and providing recommendations for patient care or coverage decisions. These nurses typically work remotely or in office settings and may be responsible for communicating findings to healthcare providers or insurance adjusters. This role requires strong clinical knowledge, attention to detail, and excellent communication skills.

What is the difference between Contract Rn Case Review vs Contract Rn Case Management?

AspectContract Rn Case ReviewContract Rn Case Management
CertificationsRN license, case review certificationsRN license, case management certifications (e.g., CCM)
Work EnvironmentReviewing medical records, assessing casesCoordinating patient care, managing cases
Employer & IndustryInsurance companies, healthcare agenciesHealthcare providers, insurance companies
Search & Comparison IntentUnderstanding case review roles, job differencesExploring case management careers, job duties

Contract Rn Case Review focuses on evaluating medical records and determining coverage or compliance, while Contract Rn Case Management involves coordinating patient care and managing cases throughout treatment. Both roles require RN licensure, but they differ in daily tasks and responsibilities within the healthcare and insurance industries.

What cities are hiring for Contract Rn Case Review jobs? Cities with the most Contract Rn Case Review job openings:
What are the most commonly searched types of Rn Case Review jobs? The most popular types of Rn Case Review jobs are:
What states have the most Contract Rn Case Review jobs? States with the most job openings for Contract Rn Case Review jobs include:
Contract Rn Case Review jobs near you

Registered Nurse - Case Manager

Collabera Technologies

Hopewell, NJ • On-site

$33 - $34/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

Job description

Description

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Registered Nurse - Case Manager
Contract to Hire: Hopewell, New Jersey, US
Salary Range: 33.00 - 34.00 | Per Hour
Job Code: 368986
End Date: 2026-05-27
Days Left: 0 days, 20 hours left
Apply
Job Title: Clinical RN I - Utilization Management (Inpatient Case Management)
Job Location: Hopewell, New Jersey 08534 (Onsite)
Job Duration: 3 Months Contract
Pay Rate: $33.00 to $34.00/hr
Job Description:
Role Summary
  • The Clinical RN I - Utilization Management (Inpatient Case Management) is responsible for conducting structured pre-pay and post-pay clinical documentation audits in alignment with state audit requirements and internal guidelines.
  • This role involves reviewing clinical documentation, validating authorizations, and comparing cases against medical necessity criteria (MCG) to support payment integrity and compliance.
  • The RN works within defined workflows and guidelines and does not make final medical necessity determinations independently, but escalates cases as required.
Key Responsibilities
  1. Pre-Pay / Post-Pay Audit Execution
  • Perform daily clinical documentation audits using the State Audit Process Guide
  • Review claims from daily triage reports and process cases individually
  • Access and evaluate claim documentation via ECM/DMS systems
  • Review audit findings documented within case files
  1. Clinical Documentation Review
  • Assess clinical records for completeness and accuracy
  • Validate authorizations using Care Radius
  • Apply and compare MCG criteria with audit findings
  • Attach relevant supporting clinical criteria for audit decisions
  1. Audit Documentation & Tracking
  • Document findings using standardized audit templates
  • Clinical findings
  • Ensure accurate and timely audit logs
  1. Compliance & Quality Assurance
  • Adhere to state regulations, internal policies, and confidentiality standards
  • Identify documentation gaps and escalate as needed
  • Maintain consistency and accuracy in audit processes
  1. Collaboration & Communication
  • Communicate audit findings with internal teams and leadership
  • Participate in training, calibration sessions, and quality reviews
  • Implement feedback to improve audit performance

Systems & Tools:
  • Excel (Audit Tracker & Reporting)
  • ECM / DMS (ITS) - document management
  • Care Radius - authorization validation
  • MCG - medical necessity guidelines
  • Outlook / MS Teams - communication
Required Qualifications
  • Active, unrestricted Registered Nurse (RN) license
  • ASN or BSN degree
  • Strong analytical and documentation skills
  • Ability to follow structured workflows and apply clinical criteria
Preferred Qualifications
  • Experience in pre-pay or post-pay audits
  • Familiarity with MCG guidelines
  • Experience with audit trackers and document systems
  • Exposure to state or regulatory audits
The Company offers the following benefits for this position, subject to applicable eligibility requirements: medical insurance, dental insurance, vision insurance, 401(k) retirement plan, life insurance, long-term disability insurance, short-term disability insurance, paid parking/public transportation, paid time off, paid sick and safe time, hours of paid vacation time, weeks of paid parental leave, and paid holidays annually - as applicable.
Job Requirement
  • Utilization Review Nurse
  • Utilization Management Nurse
  • UM Nurse
  • Inpatient Case Manager (RN)
  • RN Case Manager
  • Clinical Case Manager
  • Nurse Case Manager
  • Clinical Review Nurse
  • Clinical Documentation Review Nurse
  • Clinical Documentation Specialist (RN)
  • DRG Validation Nurse
  • Clinical Auditor (RN)
  • Nurse Auditor
  • Audit Nurse
  • Payment Integrity Nurse
  • Quality Assurance Nurse (Clinical)
  • Managed Care Nurse
  • Health Plan Nurse
  • Medical Review Nurse
  • Care Management Nurse
  • Prior Authorization Nurse
  • Authorization Review Nurse
  • Registered Nurse Case Manager
  • Clinical Analyst (RN)
  • Population Health Nurse
  • Care Coordinator (RN)
Reach Out to a Recruiter
  • Recruiter
  • Email
  • Phone
  • Prince Singh
  • prince.singh@collabera.com

Apply Now

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