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Full Time Remote Clinical Reviewer information

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How much do full time remote clinical reviewer jobs pay per hour?

As of Aug 18, 2026, the average hourly pay for full time remote clinical reviewer in the United States is $35.92, according to ZipRecruiter salary data. Most workers in this role earn between $31.25 and $40.38 per hour, depending on experience, location, and employer.

What is a full time remote clinical reviewer?

A Full Time Remote Clinical Reviewer is a healthcare professional, often a nurse or physician, who evaluates medical records and clinical documentation from a remote location. Their primary role is to assess the medical necessity, appropriateness, and quality of healthcare services provided to patients, ensuring compliance with regulatory and insurance guidelines. They typically work for insurance companies, healthcare providers, or third-party review organizations. By working remotely, they can access digital medical records and communicate with other healthcare professionals through secure online systems. This role helps improve patient care, streamline billing processes, and reduce unnecessary medical costs.

What are the key skills and qualifications needed to thrive as a full time remote clinical reviewer?

To thrive as a Full Time Remote Clinical Reviewer, you need a solid background in healthcare, clinical assessment, and medical terminology, typically supported by a valid clinical license such as RN, LPN, or similar. Familiarity with utilization management software, electronic health record (EHR) systems, and relevant certifications like URAC or InterQual is often required. Strong attention to detail, critical thinking, and effective written communication are crucial soft skills for this role. These skills ensure accurate clinical evaluations, regulatory compliance, and clear communication in a remote work environment, directly impacting patient outcomes and organizational efficiency.

How does a full time remote clinical reviewer typically collaborate with healthcare providers and team members while working remotely?

As a Full Time Remote Clinical Reviewer, you will regularly collaborate with physicians, nurses, and administrative staff through secure digital platforms such as email, video conferencing, and electronic health record (EHR) systems. Effective communication is essential to clarify case details, obtain additional documentation, and ensure reviews meet compliance and quality standards. Despite working remotely, you will often participate in virtual team meetings, case discussions, and ongoing training sessions to stay updated on protocols and best practices.

What is the difference between Full Time Remote Clinical Reviewer vs Part Time Remote Clinical Reviewer?

AspectFull Time Remote Clinical ReviewerPart Time Remote Clinical Reviewer
Work HoursTypically 40 hours/weekLess than 20 hours/week
CertificationsRequired clinical credentials (e.g., RN, LPN, or relevant license)Same as full-time, but flexible scheduling
Work EnvironmentRemote, home-basedRemote, home-based
Employer UsageCommon in healthcare and insurance companiesSimilar, often for supplemental or flexible roles

Full Time Remote Clinical Reviewers work standard hours and are employed full-time, focusing on comprehensive case reviews. Part Time Remote Clinical Reviewers have flexible schedules with fewer hours, often for supplemental work. Both roles require relevant clinical credentials and are performed remotely within healthcare and insurance industries.

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Cities with the most Full Time Remote Clinical Reviewer job openings:

What are the most commonly searched types of Remote Clinical Reviewer jobs?

The most popular types of Remote Clinical Reviewer jobs are:

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States with the most job openings for Full Time Remote Clinical Reviewer jobs include:

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The top searched job categories for Full Time Remote Clinical Reviewer jobs are:

Full Time Remote Clinical Reviewer jobs near you
Infographic showing various Full Time Remote Clinical Reviewer job openings in the United States as of August 2026, with employment types broken down into 4% As Needed, 70% Full Time, 17% Part Time, and 9% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $74,707 per year, or $35.9 per hour.

Remote Pharmacist - Medicare Part D- Clinical Review Specialist

A-Line Staffing Solutions

Charlotte, NC • Remote

$53/hr

Full-time

This job post has expired 1 day ago. Applications are no longer accepted.

Job description

A-Line Staffing is now hiring a Pharmacist -Medicare Part D- Clinical Review Specialist. This would be full time / 40+ hours per week.

Pharmacist -Medicare Part D- Clinical Review Specialist Hours

  • START DATES - 10/12, 10/19, 10/26
  • 8-10 weeks of training - M-F - 9am-5:30pm EST (no vacation time planned).
  • 40 hours per week, potential overtime
  • Must be able to work ANY 8 hour shift from 7am - 8pm EST Monday – Friday
  • 7am - 430pm EST Sat and Sunday. Rotating weekends
  • FULLY REMOTE

Pharmacist -Medicare Part D- Clinical Review Specialist Compensation

  • The pay for this position is between $53.00 an hour
  • Benefits are available to full-time employees after 90 days of employment
  • A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates

Pharmacist -Medicare Part D- Clinical Review Specialist Responsibilities

  • Support Medicare Part D members and providers with pharmacy benefit and coverage determination requests.
  • Ensure accurate case setup and complete clinical review of Medicare appeals in compliance with CMS guidelines.
  • Review clinical information and make appropriate determinations based on drug compendia and clinical judgment.
  • Conduct provider outreach for additional clinical clarification when necessary.
  • Accurately document all Medicare Part D requests and maintain compliance with CMS-mandated timelines.
  • Meet or exceed departmental productivity and quality standards.

Pharmacist -Medicare Part D- Clinical Review Specialist Requirements

  • Licensed Pharmacist
  • Knowledge of Medicare Part D regulations, including coverage determinations and appeals (CMS guidelines)
  • Experience with PBMS, Utilization Management or Prior Authorization review highly preferred

If you think this Pharmacist -Medicare Part D- Clinical Review Specialist Position is a good fit for you, please reach out to me - feel free to call, e-mail, or apply to this posting!

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About A-Line Staffing Solutions

Sourced by ZipRecruiter

A-Line Staffing Solutions is an established full-service recruiting and staffing provider that operates in the industry of human resources and recruitment. Based in Utica, Michigan, A-Line Staffing Solutions has been committed to its mission of providing innovative and effective workforce solutions since its foundation. The company specializes in providing high-quality staffing solutions for a range of disciplines, including Information Technology, Professional, Administrative, Healthcare, and more. A-Line prides itself on its ability to offer comprehensive and tailored staffing solutions in line with the varying needs of different businesses, which has played a crucial role in the company's growth and success.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Utica, MI, US

Year founded

2004

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