$78K - $88K/yr
Nurse Reviewer (Registered Nurse) - Remote It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ...
New
$78K - $88K/yr
Nurse Reviewer (Registered Nurse) - Remote It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ...
New
Reading, PA · Remote
$40/hr
Nurse Reviewer PT (20-30 hours week) - Remote Work Environment Non-Exempt: $40.00 hour Supports Medical Review Services. The Nurse Reviewer plays a critical role in supporting the Medical Review ...
Reading, PA · Remote
$40/hr
Nurse Reviewer PT (20-30 hours week) - Remote Work Environment Non-Exempt: $40.00 hour Supports Medical Review Services. The Nurse Reviewer plays a critical role in supporting the Medical Review ...
Williamsport, PA · Remote
$40/hr
Nurse Reviewer PT (20-30 hours week) - Remote Work Environment Non-Exempt: $40.00 hour Supports Medical Review Services. The Nurse Reviewer plays a critical role in supporting the Medical Review ...
Williamsport, PA · Remote
$40/hr
Nurse Reviewer PT (20-30 hours week) - Remote Work Environment Non-Exempt: $40.00 hour Supports Medical Review Services. The Nurse Reviewer plays a critical role in supporting the Medical Review ...
Orlando, FL · Remote
$40/hr
Nurse Reviewer PT (20-30 hours week) - Remote Work Environment Non-Exempt: $40.00 hour Supports Medical Review Services. The Nurse Reviewer plays a critical role in supporting the Medical Review ...
Orlando, FL · Remote
$40/hr
Nurse Reviewer PT (20-30 hours week) - Remote Work Environment Non-Exempt: $40.00 hour Supports Medical Review Services. The Nurse Reviewer plays a critical role in supporting the Medical Review ...
Tampa, FL · Remote
$40/hr
Nurse Reviewer PT (20-30 hours week) - Remote Work Environment Non-Exempt: $40.00 hour Supports Medical Review Services. The Nurse Reviewer plays a critical role in supporting the Medical Review ...
Tampa, FL · Remote
$40/hr
Nurse Reviewer PT (20-30 hours week) - Remote Work Environment Non-Exempt: $40.00 hour Supports Medical Review Services. The Nurse Reviewer plays a critical role in supporting the Medical Review ...
Allentown, PA · Remote
$40/hr
Nurse Reviewer PT (20-30 hours week) - Remote Work Environment Non-Exempt: $40.00 hour Supports Medical Review Services. The Nurse Reviewer plays a critical role in supporting the Medical Review ...
Allentown, PA · Remote
$40/hr
Nurse Reviewer PT (20-30 hours week) - Remote Work Environment Non-Exempt: $40.00 hour Supports Medical Review Services. The Nurse Reviewer plays a critical role in supporting the Medical Review ...
$66K - $106K/yr
Overnight travel may be required. * Telework available from contiguous United States ... as a Registered Nurse or other clinician, and/or experience in review of medical claims for ...
$66K - $106K/yr
Overnight travel may be required. * Telework available from contiguous United States ... as a Registered Nurse or other clinician, and/or experience in review of medical claims for ...
Sarasota, FL · Remote
$40/hr
Nurse Reviewer PT (20-30 hours week) - Remote Work Environment Non-Exempt: $40.00 hour Supports Medical Review Services. The Nurse Reviewer plays a critical role in supporting the Medical Review ...
Sarasota, FL · Remote
$40/hr
Nurse Reviewer PT (20-30 hours week) - Remote Work Environment Non-Exempt: $40.00 hour Supports Medical Review Services. The Nurse Reviewer plays a critical role in supporting the Medical Review ...
$66K - $106K/yr
Overnight travel may be required. * Telework available from contiguous United States ... as a Registered Nurse or other clinician, and/or experience in review of medical claims for ...
$66K - $106K/yr
Overnight travel may be required. * Telework available from contiguous United States ... as a Registered Nurse or other clinician, and/or experience in review of medical claims for ...
$66K - $106K/yr
Overnight travel may be required. * Telework available from contiguous United States ... as a Registered Nurse or other clinician, and/or experience in review of medical claims for ...
$66K - $106K/yr
Overnight travel may be required. * Telework available from contiguous United States ... as a Registered Nurse or other clinician, and/or experience in review of medical claims for ...
$35 - $37/hr
Lead RN Reviewer Cohere's Service Operations team is responsible for ensuring that our healthcare ... Fully remote opportunity with about 5% travel Medical, dental, vision, life, disability insurance ...
$35 - $37/hr
Lead RN Reviewer Cohere's Service Operations team is responsible for ensuring that our healthcare ... Fully remote opportunity with about 5% travel Medical, dental, vision, life, disability insurance ...
$35 - $37/hr
Lead RN Reviewer Cohere's Service Operations team is responsible for ensuring that our healthcare ... Fully remote opportunity with about 5% travel Medical, dental, vision, life, disability insurance ...
$35 - $37/hr
Lead RN Reviewer Cohere's Service Operations team is responsible for ensuring that our healthcare ... Fully remote opportunity with about 5% travel Medical, dental, vision, life, disability insurance ...
$78K - $88K/yr
Reviews and interprets medical records against criteria to assess appropriateness and ... Remote position; employees must be located within the continental U.S. while working. * Work ...
$78K - $88K/yr
Reviews and interprets medical records against criteria to assess appropriateness and ... Remote position; employees must be located within the continental U.S. while working. * Work ...
Saint Marys, PA · On-site +1
Remote Position AS AN OASIS REVIEWER you will be responsible to provide guidance, regulatory ... Registered Nurse with current PA Nursing Licensure * A minimum 3-5 years of home health experience ...
Saint Marys, PA · On-site +1
Remote Position AS AN OASIS REVIEWER you will be responsible to provide guidance, regulatory ... Registered Nurse with current PA Nursing Licensure * A minimum 3-5 years of home health experience ...
Denver, CO · Remote
Remote Nurse Practitioner Classification: 1099 Independent Contractor Work Structure: Fully Remote ... review * Develop and manage individualized care plans for patients with chronic lung conditions
Quick apply
Denver, CO · Remote
Remote Nurse Practitioner Classification: 1099 Independent Contractor Work Structure: Fully Remote ... review * Develop and manage individualized care plans for patients with chronic lung conditions
Denver, CO · On-site +1
Remote Nurse Practitioner Classification: 1099 Independent Contractor Work Structure: Fully Remote ... review * Develop and manage individualized care plans for patients with chronic lung conditions
Denver, CO · On-site +1
Remote Nurse Practitioner Classification: 1099 Independent Contractor Work Structure: Fully Remote ... review * Develop and manage individualized care plans for patients with chronic lung conditions
OR · On-site +1
Remote (U.S. - Work from home) Remote Work Requirements : High-speed internet (non-satellite) and a ... About the Role We are seeking a dedicated Registered Nurse (RN) to join our Medical Review team
OR · On-site +1
Remote (U.S. - Work from home) Remote Work Requirements : High-speed internet (non-satellite) and a ... About the Role We are seeking a dedicated Registered Nurse (RN) to join our Medical Review team
Remote Nurse Practitioner Classification: 1099 Independent Contractor Work Structure: Fully Remote ... review * Develop and manage individualized care plans for patients with chronic lung conditions
Remote Nurse Practitioner Classification: 1099 Independent Contractor Work Structure: Fully Remote ... review * Develop and manage individualized care plans for patients with chronic lung conditions
Denver, CO · Remote
Job Title:Remote Nurse Practitioner Classification: 1099 Independent Contractor Work Structure ... review * Develop and manage individualized care plans for patients with chronic lung conditions
Denver, CO · Remote
Job Title:Remote Nurse Practitioner Classification: 1099 Independent Contractor Work Structure ... review * Develop and manage individualized care plans for patients with chronic lung conditions
Clinical Utilization Review Nurses (RN) Based In Alabama Comagine Health is a national, mission ... We go beyond merely providing a remote work option; we support and embrace it. We offer ...
Clinical Utilization Review Nurses (RN) Based In Alabama Comagine Health is a national, mission ... We go beyond merely providing a remote work option; we support and embrace it. We offer ...
$28.37 - $29.68
12% of jobs
$29.68 - $30.99
4% of jobs
$30.99 - $32.30
3% of jobs
$32.30 - $33.61
3% of jobs
$33.81 is the 25th percentile. Wages below this are outliers.
$33.61 - $34.92
16% of jobs
$34.92 - $36.23
6% of jobs
The median wage is $37.22 / hr.
$36.23 - $37.54
6% of jobs
$37.54 - $38.85
10% of jobs
$38.85 - $40.17
1% of jobs
$40.94 is the 75th percentile. Wages above this are outliers.
$40.17 - $41.48
22% of jobs
$41.48 - $42.79
16% of jobs
$28
$37
$42
| Aspect | Overnight Remote Nurse Reviewer | Telehealth Nurse |
|---|---|---|
| Credentials | RN license, clinical review certification | RN license, may include telehealth-specific training |
| Work Environment | Remote, primarily reviewing medical records overnight | Remote or clinical setting, providing patient care via telecommunication |
| Employer & Industry | Insurance companies, healthcare review organizations | Hospitals, clinics, telehealth platforms |
| Primary Tasks | Reviewing medical records for accuracy and compliance | Assessing patient symptoms, providing medical advice remotely |
While both roles require RN licensure and involve remote work, the Overnight Remote Nurse Reviewer focuses on reviewing medical records overnight, whereas the Telehealth Nurse provides direct patient care remotely during regular hours. The roles differ mainly in daily responsibilities and work hours, but both serve the healthcare industry through remote nursing services.
Cities with the most Overnight Remote Nurse Reviewer job openings:
The most popular types of Remote Nurse Reviewer jobs are:
States with the most job openings for Overnight Remote Nurse Reviewer jobs include:
The top searched job categories for Overnight Remote Nurse Reviewer jobs are:
$78K - $88K/yr
Other
Medical, Dental, Vision, Retirement, PTO
Posted 2 days ago
New
7.8
Based on 82 frontline employees who took The Breakroom Quiz
137th of 245 rated software companies
It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you'll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.
Summary: We are seeking a Nurse Reviewer (RN) who will be responsible for performing clinical reviews to determine whether medical record documentation supports the need for services based on clinical criteria, coverage policies, and utilization and practice guidelines. This role involves accessing proprietary systems to review medical records, accurately documenting findings, and providing policy and regulatory support for review determinations.
Your role in our mission: Reviews and interprets medical records to determine medical necessity and appropriateness of care while meeting quality and productivity standards. Documents review decisions and supporting rationale accurately and timely. Determines approvals or refers cases to physician consultants and processes consultant decisions. Performs prior authorization, precertification, and retrospective reviews; prepares decision letters as needed. Assists with training, mentoring, and supporting new Nurse Reviewers. Maintains RN licensure and knowledge of clinical criteria, policies, and regulations. Cross-trains on multiple claim types to support business needs. Recommends process improvements and technology solutions to enhance quality, productivity, and client satisfaction.
What we're looking for: Proficiency in computer and typing skills, including Microsoft Windows, Outlook, Excel, Word, PowerPoint, and internet browsers. Active, unrestricted RN license in the United States and primary state of residence, along with an active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC). Minimum of 5+ years of clinical experience in an inpatient hospital setting. Minimum of 2+ years of utilization review or claims auditing experience. Experience using Milliman or InterQual criteria. Ability to work standard business hours, collaborate effectively with cross-functional teams and departments, and maintain the flexibility to work extended hours as needed to support business demands.
What you should expect in this role: Full-time position. Day-one eligibility for medical, dental, vision, and paid time off benefits. Monday through Friday work schedule. Remote role available to employees residing within the United States. Travel requirement: 0-10%. The pay range for this position is $78,000.00 - $88,000.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You'll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.
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With Health and Cost outcomes that pierce Inequities and Impact Economies, the success of our Nation’s Federal Medicaid program is inextricably tied to the Prosperity of Communities, States and the Nation as a whole. We think that deserves Respect and a Commitment from Innovators who can help those who operate within and around health and human services evolve to meet their goals. At Gainwell, that’s our Sole focus. Built across more than Five Decades, Gainwell has intentionally seized opportunities to advance its digitally enabled services to meet Agencies, Health plans and MCOs where they are on their modernization journeys and propel them into the future of Healthcare. Equally important to our Expanding Technologies and Results. We bring ideas that bring policies to life.
Health care and social assistance
10,000+ Employees
Irving, TX, US
