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Evening Remote Rn Chart Review Jobs in Arizona (NOW HIRING)

CVS Health

Case Manager, Registered Nurse

Phoenix, AZ · Remote

$54K - $155K/yr

Position Summary This is a remote work from home role anywhere in the US with virtual training ... Perform medical necessity reviews. Required Qualifications * 5+ years' experience as a Registered ...

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All JobsEvening Remote Rn Chart Review JobsEvening Remote Rn Chart Review Jobs in Arizona

Evening Remote Rn Chart Review information

Is 8pm in the evening or night?

For an Evening Remote RN Chart Review role, 8pm is generally considered evening, as it falls within typical evening hours from around 5pm to 9pm. However, some employers may define evening hours differently, so it's important to confirm specific scheduling expectations. In healthcare, night shifts usually start around 10pm or later.

Is evening 5 or 6 pm?

For an Evening Remote RN Chart Review position, the evening shift typically starts around 5 pm and may extend until 9 or 10 pm, depending on the employer's schedule. Some roles may also have a 6 pm start time, so it is best to confirm the specific hours with the employer or job posting. Flexibility and familiarity with electronic health record systems are often required for this shift.

What is the difference between Evening Remote Rn Chart Review vs Evening Remote Rn Case Management?

AspectEvening Remote Rn Chart ReviewEvening Remote Rn Case Management
Primary FocusReviewing patient charts for accuracy and complianceCoordinating patient care and discharge planning
CertificationsRN license, possibly CCRN or similarRN license, case management certification preferred
Work EnvironmentRemote, primarily administrativeRemote, involves communication with patients and providers
Industry UsageHospitals, insurance companies, healthcare agenciesHospitals, insurance companies, healthcare agencies

While both roles require RN licensure and are performed remotely, Evening Remote Rn Chart Review focuses on analyzing patient records for accuracy, whereas Evening Remote Rn Case Management involves active patient coordination and discharge planning. Understanding these differences helps professionals choose the role that best fits their skills and career goals.

What time is the evening?

For an Evening Remote RN Chart Review position, the evening typically refers to hours between 4:00 PM and 12:00 AM. The specific schedule may vary depending on the employer or shift requirements, but evening shifts generally start in the late afternoon and end at night. Flexibility and adherence to assigned hours are important for this role.

Is 4pm called evening?

In the context of an Evening Remote RN Chart Review job, 4pm is generally considered part of the evening shift, which typically runs from late afternoon to night. However, the exact definition of evening hours can vary by employer, with some considering evening as starting around 5 or 6 pm. It is important to check the specific schedule details provided by the employer for accurate shift timing.
What are the most commonly searched types of Remote Rn Chart Review jobs in Arizona? The most popular types of Remote Rn Chart Review jobs in Arizona are:
What cities in Arizona are hiring for Evening Remote Rn Chart Review jobs? Cities in Arizona with the most Evening Remote Rn Chart Review job openings:
Evening Remote Rn Chart Review jobs near you
Utilization Management Clinical Reviewer (Remote)

Utilization Management Clinical Reviewer (Remote)

Professional Health Care Network (PHCN)

Phoenix, AZ • Remote

Full-time

Posted 3 days ago

Job description

The Utilization Management (UM) Clinical Reviewer is responsible for performing utilization review activities to ensure the appropriate, efficient, and cost-effective use of home health services. This role evaluates medical necessity for skilled nursing and therapy services (physical therapy, occupational therapy, and speech-language pathology) in accordance with company policies, CMS guidelines (including Medicare Chapter 7), and established clinical criteria such as Milliman Care Guidelines.

The UM Clinical Reviewer collaborates with providers, internal teams, and payer partners to promote high-quality patient outcomes, ensure regulatory compliance, and support optimal care planning across disciplines.

The schedule for this role is Tuesday - Saturday (fully remote)

Key Responsibilities:

  • Review and process prior authorization, reauthorization, and continued stay requests for home health services (nursing and therapy)
  • Evaluate medical records and clinical documentation to determine medical necessity and appropriateness of care
  • Apply CMS guidelines, NCQA standards, and internal clinical policies when making authorization determinations
  • Refer complex or non-compliant cases to Physician Advisors or Medical Directors as appropriate
  • Collaborate with providers to support appropriate utilization of skilled nursing and therapy visits
  • Serve as a clinical resource to internal team members and external partners, including providers, payers, and case managers
  • Facilitate effective communication to ensure alignment on care plans, documentation standards, and authorization decisions
  • Monitor adherence to home health regulations, documentation standards, and medical necessity criteria
  • Maintain accurate and timely documentation of reviews, decisions, and communications
  • Identify trends or issues impacting quality or utilization and escalate to leadership or quality committees as needed 7
  • Participate in interdisciplinary collaboration and support continuous improvement initiatives
  • Meet productivity, turnaround time, and quality standards for review completion 8
  • Participate in periodic weekend/holiday coverage based on business needs 9 10
  • Perform additional duties as assigned

Office Location:

  • Office located at 2415 E Camelback Road, Suite 700, Phoenix, AZ 85016
  • Remote

Qualifications:

Education & Licensure (one of the following required):

  • Graduate of an accredited nursing program (RN, LPN, or LVN), or
  • Graduate of an accredited Physical Therapy (PT), Occupational Therapy (OT), or Speech-Language Pathology (SLP) program
  • Active, unrestricted clinical license in good standing (multi-state licensure preferred where applicable)

Experience:

  • Minimum 2-5 years of clinical experience (home health, medical/surgical, or therapy setting)
  • Experience in utilization review, case management, or managed care strongly preferred
  • Home health experience strongly preferred

Knowledge and Experience:

  • Strong understanding of home health regulations, CMS guidelines, and medical necessity criteria
  • Knowledge of utilization management principles and care coordination practices
  • Familiarity with NCQA and URAC standards preferred
  • Ability to analyze clinical documentation and make independent, evidence-based decisions
  • Excellent written and verbal communication skills
  • Strong organizational skills with the ability to manage multiple priorities and meet deadlines
  • Ability to work independently while collaborating effectively across teams
  • Customer-service oriented mindset when working with providers and partners
  • Proficiency in Microsoft Office and electronic medical management systems

Additional Expectations

Employees are expected to:

  • Participate in ongoing education and training
  • Stay current on regulatory updates and clinical guidelines
  • Contribute to a culture of quality, compliance, and continuous improvement

tango provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. tango will make reasonable accommodations for qualified individuals with known disabilities unless doing so would result in an undue hardship.

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