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Medical Review Rn Jobs (NOW HIRING)

LifeHealth

Medical Review RN

Washington, DC

Medical Review RN * Date: Start Date - TBD * Shift Time: 0800-1630 M-F * Location: Washington, DC Position Summary: LifeHealth Medical Review Nurse (MRN) is responsible for the initial chart review ...

LifeHealth

Medical Review RN

Washington, DC

Medical Review RN * Date: Start Date - TBD * Shift Time: 0800-1630 M-F * Location: Washington, DC Position Summary: LifeHealth Medical Review Nurse (MRN) is responsible for the initial chart review ...

Lifehealth LLC

Medical Review RN

Washington, DC · On-site

$45/hr

Medical Review RN * Date: Start Date - TBD * Shift Time: 0800-1630 M-F * Location: Washington, DC Position Summary: LifeHealth Medical Review Nurse (MRN) is responsible for the initial chart review ...

Schneck Medical Center

UTILIZATION REVIEW RN

Seymour, IN · On-site

$30.72/hr

Bachelors Degree in Nursing with case management certification LICENSE/CERTIFICATION Licensed RN in ... medical necessity criter and payer requirements JOB DUTIES 1. Utilization Review and Medical ...

CHI Health

Utilization Review RN

Omaha, NE

$33.51 - $48.58/hr

Collaborates with facility RN Care Coordinators to ensure progression of care. Engages the second level physician reviewer, internal or external, as indicated to support the appropriate status.

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How much do medical review rn jobs pay per hour?

As of Jun 9, 2026, the average hourly pay for medical review rn in the United States is $44.91, according to ZipRecruiter salary data. Most workers in this role earn between $34.38 and $53.37 per hour, depending on experience, location, and employer.

What is a Medical Review RN?

A Medical Review RN is a registered nurse who specializes in reviewing medical records and claims to ensure they meet established guidelines and standards. These nurses often work for insurance companies, government agencies, or healthcare organizations, evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. Their role may include determining medical necessity, performing utilization reviews, and supporting appeals or audits. They use their clinical knowledge to interpret complex medical information and collaborate with healthcare providers to support accurate decision-making.

How to become a medical review nurse?

To become a medical review nurse, one must typically earn a nursing license by completing an accredited nursing program and passing the NCLEX-RN exam. Experience in clinical nursing and knowledge of medical coding, documentation, and healthcare regulations are also important, and some roles may require certification in case management or utilization review.

How does a Medical Review RN collaborate with other healthcare professionals during the review process?

A Medical Review RN often works closely with physicians, case managers, and insurance representatives to ensure that medical claims and treatment plans meet regulatory and clinical guidelines. Collaboration may involve participating in interdisciplinary meetings, discussing complex cases, and providing clinical expertise to support utilization management decisions. Effective communication and teamwork are essential, as you'll need to relay findings, request additional information, and sometimes clarify medical necessity with providers. This collaborative environment helps ensure quality care for patients while maintaining compliance with payer policies.

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

To thrive as a Medical Review RN, you need a strong clinical background, critical thinking skills, and an active RN license, often supported by experience in case management or utilization review. Familiarity with medical coding, claims management software, and knowledge of regulatory guidelines such as Medicare and Medicaid are typically required. Strong attention to detail, excellent written communication, and the ability to work independently are essential soft skills for this role. These competencies ensure accurate and compliant medical record reviews, which are critical for proper claims adjudication and regulatory adherence.
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Medical Review RN jobs near you
Infographic showing various Medical Review Rn job openings in the United States as of June 2026, with employment types broken down into 1% As Needed, 88% Full Time, 5% Part Time, and 6% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $93,419 per year, or $44.9 per hour.
Medical Review RN

Medical Review RN

LifeHealth

Washington, DC

Other

Posted 4 days ago

Job description

Description
LifeHealth LLC (LifeHealth), a professional services company specializing in worksite wellness services, clinical staffing, and healthcare readiness is looking for qualified Registered Nurses (RN) responsible for the initial chart review and chart case management for medical exam/screening programs to verify that all medical information and exam components are accurate. The
RN works directly with Physicians and Examinees to ensure all medical information is gathered and performs medical Quality Assurance on all charts in various process stages leading to a final
determination.
  • Position: Medical Review RN
  • Date: Start Date - TBD
  • Shift Time: 0800-1630 M-F
  • Location: Washington, DC
Position Summary:
LifeHealth Medical Review Nurse (MRN) is responsible for the initial chart review and chart case management for medical exam/screening programs to verify that all medical information and exam components are accurate. The RN works directly with Physicians and Examinees to ensure all medical information is gathered and performs medical Quality Assurance on all charts in various process stages leading to a final determination. This position is temporary short-term position for 6-8 weeks with possible extension.
Essential Duties and Responsibilities include, but are not limited to the following:
  • Performs medical review of incoming charts to determine if additional medical information is needed.
  • Collaborates with Physician(s) and other internal nursing staff members f or chart review.
  • Performs medical Quality Assurance (QA) on all charts in various process stages.
  • Interfaces with Client's Medical Department as well as the on-site provider.
  • Contacts Examinee via telephone or email to clarify information necessary to complete the chart.
  • Develops a very good understanding of the specific contract's guidelines and addendums as required.
  • Masters the various software programs specific to the functioning of the exam program.
  • Implements and follows up on requests for further evaluation from the Examinee when required.
  • Works closely with other departments to provide accurate and quality outcomes.
  • Thoroughly cognizant of metrics and organizes workload to meet them.
  • Consistently learns and applies codified state and federal regulations specific to particular contract(s).
  • Serve as backup to other nurses f or daily duties and assists with follow-up calls to facilities and Examinees as needed as well as other duties as assigned.
  • Opportunity to travel and assist on medical mobile events as either a site lead and/or RN as work or personal schedule permit.
  • May participate in interdepartmental project groups or task forces to integrate activities, communicate issues, obtain approvals, resolve problems, and maintain a specif ic level of knowledge pertaining to new
    developments, new task efforts, contract awards, and new policy requirements.
  • Supports marketing and sales objectives and efforts as requested.
  • Performs duties in a safe manner. Follows the corporate safety policy. Participates and supports safety meetings, training, and goals. Ensures safe operating conditions within an area of responsibility.
    Encourages co-workers to work safely. Identifies "close calls" and/or safety concerns to supervisory
    personnel. Maintains a clean and orderly work area.
  • Assists in the active implementation of company initiatives to ensure compliance with OSHA VPP, ISO, JCAHO, AAAHC, and other mandated regulations/standards.
  • May serve on the OSHA VPP, Safety, and Wellness Committees.
Qualifications/Knowledge Skills & Abilities:
  • 5-7 years of relevant experience.
  • Fully unencumbered nursing license to work in Washington DC required.
  • Proficiency with computer and common office equipment, as well as with MS Office products.
  • Must be able to multitask, be flexible, be organized, and have excellent oral and written communication skills as well as exceptional attention to detail.
  • Ability to work independently and prioritize a moderate workload with minimal supervision
  • Adaptability to schedule changes on an as-need basis
  • Must be eligible to work in the US
  • Must possess reliable transportation, have a clean driving record, and current automobile insurance.
  • Must be 18 years of age or older
  • Current CPR, BLS or ACLS

Disclaimer:
LifeHealth is an Equal Employment Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
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