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Medical Review Rn Jobs in Phoenix, AZ (NOW HIRING)

TEEMA Group

Clinical Quality Review Nurse

Phoenix, AZ · Remote

$41 - $44/hr

CLINICAL QUALITY REVIEWER (RN or LCSW) Location: USA- Remote in approved states Overview: TEEMA is ... (RN) or Licensed Clinical Social Worker (LCSW) * Minimum 3+ years of clinical experience (medical ...

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

You will perform frequent case reviews, check medical records and speak with care providers ... Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate ...

TEEMA Group

REMOTE RN - Quality Review

Phoenix, AZ · Remote

$42 - $43.50/hr

Review medical records to identify potential quality, safety, and utilization concerns * Conduct ... Active, unrestricted license as a Registered Nurse (RN) or Licensed Clinical Social Worker (LCSW) * ...

TEEMA

RN Clinical Quality Reviewer

Phoenix, AZ · Remote

$40 - $43/hr

Job Summary RN Clinical Quality Reviewer TEEMA Full-time Remote | Phoenix, AZ, United States ... Review medical records to identify potential quality, safety, and utilization concerns * Conduct ...

The Palazzo

Registered Nurse (RN)

Phoenix, AZ · On-site

Reviews nurses' notes to ensure they are accurate/descriptive of the nursing care being provided ... Health Benefits - Medical, dental, and vision coverages with company paying majority of costs for ...

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Medical Review Rn information

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How much do medical review rn jobs pay per hour?

As of Jul 28, 2026, the average hourly pay for medical review rn in Phoenix, AZ is $44.59, according to ZipRecruiter salary data. Most workers in this role earn between $34.13 and $52.98 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.

Can I make $500,000 as a nurse?

Medical Review RNs typically do not earn $500,000 annually, as most nursing salaries are below that level. High earnings in nursing usually require advanced roles, specialized certifications, management positions, or work in high-paying industries or locations. Achieving such a salary may involve additional education, experience, and responsibilities beyond standard nursing roles.

What does a medical review RN do?

A Medical Review RN evaluates insurance claims, medical records, and provider documentation to determine coverage and compliance with policies. They ensure accurate assessment of medical necessity, often working with healthcare providers and insurance companies, and may require knowledge of medical coding and documentation standards.

How to make $300,000 as a nurse?

Medical Review RNs can increase their earnings by gaining specialized certifications, such as in case management or legal nurse consulting, and working in high-demand settings like telehealth or insurance companies. Advancing to senior or managerial roles, working overtime, or taking on consulting projects can also boost income toward $300,000 annually.

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.

How to make an extra 2000 a month as a nurse?

Medical Review RNs can increase their income by taking on additional freelance or per diem review assignments, working overtime, or obtaining specialized certifications to qualify for higher-paying roles. Developing expertise in specific medical areas or coding can also lead to higher-paying opportunities outside regular hours.

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.
What cities near Phoenix, AZ are hiring for Medical Review Rn jobs? Cities near Phoenix, AZ with the most Medical Review Rn job openings:
Medical Review Rn jobs near you
Infographic showing various Medical Review Rn job openings in Phoenix, AZ as of July 2026, with employment types broken down into 1% As Needed, 79% Full Time, 14% Part Time, and 6% Contract. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution, with an average salary of $92,757 per year, or $44.6 per hour.

Clinical Quality Review Nurse

TEEMA Group

Phoenix, AZ • Remote

$41 - $44/hr

Full-time

Posted 28 days ago

Job description

6-9 month contract to hire.

Position Overview

Job Title: CLINICAL QUALITY REVIEWER (RN or LCSW)
Location: USA- Remote in approved states
Overview:
TEEMA is partnering with a leading organization supporting a large-scale federal healthcare program to identify a Clinical Quality Reviewer. This role focuses on reviewing clinical cases, identifying potential quality or safety concerns, and supporting quality improvement initiatives across a complex healthcare delivery network. This is an excellent opportunity for a licensed clinical professional with experience in clinical review, utilization management, or healthcare quality within health plans, hospital systems, or government-supported programs.
What you will be doing:

  • Review medical records to identify potential quality, safety, and utilization concerns

  • Conduct detailed case analysis and prepare clear, well-documented summaries and recommendations

  • Support peer review processes and quality improvement initiatives

  • Analyze trends and assist in identifying patterns in care delivery and outcomes

  • Collaborate with clinical leadership, including Medical Directors, to review findings

  • Participate in quality committees and performance improvement efforts

  • Ensure compliance with regulatory requirements and program standards

  • Coordinate with cross-functional teams such as case management, care coordination, and program integrity


What you must have:

  • Active, unrestricted license as a Registered Nurse (RN) or Licensed Clinical Social Worker (LCSW)

  • Minimum 3+ years of clinical experience (medical/surgical and/or behavioral health)

  • U.S. Citizenship required

  • Ability to obtain and maintain a Department of Defense (DoD) background clearance

  • Strong analytical and critical thinking skills

  • Excellent written communication skills


Nice to have:

  • Bachelor’s degree in Nursing or healthcare-related field

  • Experience in clinical quality, utilization review, or case review

  • Familiarity with federal or government healthcare programs

  • Experience with clinical criteria tools (InterQual or similar)

  • Exposure to healthcare data analysis or reporting

Technical Skills

  • Proficiency with Microsoft Office (Word, Excel, Outlook)

  • Comfortable working across multiple systems and electronic medical records

What makes you successful

  • Strong clinical judgment and attention to detail

  • Ability to work independently and manage multiple priorities

  • Analytical mindset with problem-solving ability

  • Clear and professional communication skills

  • Comfortable working in a structured, compliance-driven environment


Other Information:

  • Remote or onsite depending on business needs

  • Must have a secure home office setup if remote

  • Occasional extended hours may be required


Salary/Rate Range: $85,000 – $92,000 annually; Hourly Equivalent: Approximately $41 – $44/hour