Assess whether a review is needed for a member's return to their own occupation, and identify the ... Work Environment You will be working in an approved remote environment within the states of:
Assess whether a review is needed for a member's return to their own occupation, and identify the ... Work Environment You will be working in an approved remote environment within the states of:
Nurse Practitioner: Remote Urgent Care
Detroit, MI ยท Remote
$109K - $151K/yr
As these issues arise, a team of remote nurses coordinate care with other healthcare providers ... Participate in clinical case reviews and quality improvement initiatives. Requirements * Active ...
Nurse Practitioner: Remote Urgent Care
Detroit, MI ยท Remote
$109K - $151K/yr
As these issues arise, a team of remote nurses coordinate care with other healthcare providers ... Participate in clinical case reviews and quality improvement initiatives. Requirements * Active ...
Nurse Practitioner: Remote Urgent Care, GA license preferred
Detroit, MI ยท Remote
$109K - $151K/yr
As these issues arise, a team of remote nurses coordinate care with other healthcare providers ... Participate in clinical case reviews and quality improvement initiatives. Requirements * Active ...
Nurse Practitioner: Remote Urgent Care, GA license preferred
Detroit, MI ยท Remote
$109K - $151K/yr
As these issues arise, a team of remote nurses coordinate care with other healthcare providers ... Participate in clinical case reviews and quality improvement initiatives. Requirements * Active ...
Computational Biologist - AI Reviewer
Dearborn, MI ยท On-site +1
$90 - $120/hr
Remote micro1 is engaging Computational Biology Experts to contribute their advanced scientific ... Develop and review problem sets, case studies, or scenarios based on real-world medicinal chemistry ...
Computational Biologist - AI Reviewer
Dearborn, MI ยท On-site +1
$90 - $120/hr
Remote micro1 is engaging Computational Biology Experts to contribute their advanced scientific ... Develop and review problem sets, case studies, or scenarios based on real-world medicinal chemistry ...
Computational Biologist - AI Reviewer
Warren, MI ยท On-site +1
$90 - $120/hr
Remote micro1 is engaging Computational Biology Experts to contribute their advanced scientific ... Develop and review problem sets, case studies, or scenarios based on real-world medicinal chemistry ...
Computational Biologist - AI Reviewer
Warren, MI ยท On-site +1
$90 - $120/hr
Remote micro1 is engaging Computational Biology Experts to contribute their advanced scientific ... Develop and review problem sets, case studies, or scenarios based on real-world medicinal chemistry ...
Computational Biologist - AI Reviewer
Detroit, MI ยท On-site +1
$90 - $120/hr
Remote micro1 is engaging Computational Biology Experts to contribute their advanced scientific ... Develop and review problem sets, case studies, or scenarios based on real-world medicinal chemistry ...
Computational Biologist - AI Reviewer
Detroit, MI ยท On-site +1
$90 - $120/hr
Remote micro1 is engaging Computational Biology Experts to contribute their advanced scientific ... Develop and review problem sets, case studies, or scenarios based on real-world medicinal chemistry ...
Computational Biologist - AI Reviewer
Sterling Heights, MI ยท On-site +1
$90 - $120/hr
Remote micro1 is engaging Computational Biology Experts to contribute their advanced scientific ... Develop and review problem sets, case studies, or scenarios based on real-world medicinal chemistry ...
Computational Biologist - AI Reviewer
Sterling Heights, MI ยท On-site +1
$90 - $120/hr
Remote micro1 is engaging Computational Biology Experts to contribute their advanced scientific ... Develop and review problem sets, case studies, or scenarios based on real-world medicinal chemistry ...
Computational Biologist - AI Reviewer
Grand Rapids, MI ยท On-site +1
$90 - $120/hr
Remote micro1 is engaging Computational Biology Experts to contribute their advanced scientific ... Develop and review problem sets, case studies, or scenarios based on real-world medicinal chemistry ...
Computational Biologist - AI Reviewer
Grand Rapids, MI ยท On-site +1
$90 - $120/hr
Remote micro1 is engaging Computational Biology Experts to contribute their advanced scientific ... Develop and review problem sets, case studies, or scenarios based on real-world medicinal chemistry ...
Computational Biologist - AI Reviewer
Ann Arbor, MI ยท On-site +1
$90 - $120/hr
Remote micro1 is engaging Computational Biology Experts to contribute their advanced scientific ... Develop and review problem sets, case studies, or scenarios based on real-world medicinal chemistry ...
Computational Biologist - AI Reviewer
Ann Arbor, MI ยท On-site +1
$90 - $120/hr
Remote micro1 is engaging Computational Biology Experts to contribute their advanced scientific ... Develop and review problem sets, case studies, or scenarios based on real-world medicinal chemistry ...
Computational Biologist - AI Reviewer
Lansing, MI ยท On-site +1
$90 - $120/hr
Remote micro1 is engaging Computational Biology Experts to contribute their advanced scientific ... Develop and review problem sets, case studies, or scenarios based on real-world medicinal chemistry ...
Computational Biologist - AI Reviewer
Lansing, MI ยท On-site +1
$90 - $120/hr
Remote micro1 is engaging Computational Biology Experts to contribute their advanced scientific ... Develop and review problem sets, case studies, or scenarios based on real-world medicinal chemistry ...
Complete comprehensive case reports and educational eligibility determinations * Exercise strong ... An extensive virtual library of peer-reviewed studies and online assessments, including online ...
Quick apply
Complete comprehensive case reports and educational eligibility determinations * Exercise strong ... An extensive virtual library of peer-reviewed studies and online assessments, including online ...
Clinical Psychologist - Remote (Direct Hire Only)
Wyoming, MI ยท On-site +1
$80K - $110K/yr
... flexible, case-based work. Focus Clinic handles the intake visit, all in-person testing, and ... Review pre-populated intake notes and standardized testing results documented by Focus Clinic ...
Clinical Psychologist - Remote (Direct Hire Only)
Wyoming, MI ยท On-site +1
$80K - $110K/yr
... flexible, case-based work. Focus Clinic handles the intake visit, all in-person testing, and ... Review pre-populated intake notes and standardized testing results documented by Focus Clinic ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Case Manager Registered Nurse (LTSS) - Field MI (Wayne and Macomb County)
Sterling Heights, MI ยท Remote
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Case Manager Registered Nurse (LTSS) - Field MI (Wayne and Macomb County)
Sterling Heights, MI ยท Remote
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Review claims data, clinical records, and assessment tools to evaluate member needs and benefit ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
In this position you will be reviewing patient charts to determine if pre-elective surgical cases ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
In this position you will be reviewing patient charts to determine if pre-elective surgical cases ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
Remote Case Reviewer information
What are the key skills and qualifications needed to thrive as a remote case reviewer?
What is the difference between Remote Case Reviewer vs Remote Claims Processor?
| Aspect | Remote Case Reviewer | Remote Claims Processor |
|---|---|---|
| Required Credentials | High school diploma or equivalent; healthcare or legal background often preferred | High school diploma or equivalent; experience in insurance or claims processing beneficial |
| Work Environment | Home-based, independent review setting | Home-based, processing insurance claims |
| Industry Usage | Healthcare, legal, insurance sectors | Insurance companies, third-party administrators |
| Common Search/Comparison | Remote Case Reviewer vs Remote Claims Processor |
While both roles are remote and involve handling cases or claims, Remote Case Reviewers primarily evaluate and assess cases, often requiring specialized knowledge in healthcare or legal fields. Remote Claims Processors focus on processing insurance claims, verifying information, and ensuring accurate payment. Understanding these differences helps job seekers identify the role that best matches their skills and career goals.
What are some common challenges remote case reviewers face, and how can they effectively manage them?
What is a remote case reviewer?

Full-time
Posted 13 days ago
Job description
About the Role
We are looking for an experienced RN Clinical Case Manager to support a disability claim review program. In this role, you will guide members through a collaborative case management process built on assessment, planning, care coordination, and ongoing evaluation. Your work directly supports improvement in members' (patients) disabling and co-morbid conditions and helps maximize their employability. You will own your caseload from start to finish and be responsible for an efficient, timely, and complete case management process.
What You'll Do
Determine the appropriate case management track for each assigned case.
Conduct telephonic clinical assessments covering activities of daily living, psycho-social factors, recent hospitalizations, current clinical status, treatment plans and medications, treating physicians, special needs, and the appropriate outreach interval for each case.
Develop customized, member-specific clinical case management plans.
Perform ongoing periodic telephonic outreach at intervals set during the initial clinical assessment.
Request and track receipt of the records and documentation needed to identify ongoing case management needs.
Build and maintain a case management resource library to provide members with information relevant to their conditions.
Assess whether a review is needed for a member's return to their own occupation, and identify the appropriate physician specialty when it is.
Collaborate with vocational specialists during the case management process when needed.
Conduct thorough, ongoing quality review of all case documentation and ensure completeness and accuracy of case paperwork.
Communicate with members, physicians, employers, and clients as appropriate.
Enter case activities into the case management system accurately and within client-required timeframes.
Maintain compliance with applicable practice standards and guidelines, including strict confidentiality and HIPAA adherence.
What You'll Bring
Unrestricted RN licensure, without sanctions.
Current certification in case management or a related field, or the ability to qualify for certification testing within six months of hire.
Minimum of five years of clinical experience.
Minimum of five years of case management experience in one or more of the following: medical, workers' compensation, auto, or disability case management.
Working knowledge of diagnostic coding (ICD-10).
Strong critical thinking, decision-making, and organizational skills with close attention to detail.
Ability to meet deadlines and turnaround times consistently.
Ability to work independently as well as within a team.
Computer literacy, including solid working knowledge of Microsoft Word and Excel.
Strong written, verbal, and telephonic communication skills, with the ability to manage multiple priorities.
Bachelor's degree in nursing or a health-related field.
Working knowledge of the insurance industry, medical claims, and/or disability claims.
Experience with Lean production management.
Work Environment
You will be working in an approved remote environment within the states of: Michigan, Illinois, Florida, Texas, or Minnesota. Stressful conditions may arise when the workload becomes more demanding than usual.
About Managed Medical Review Organization
Sourced by ZipRecruiter
Industry
Public administration
Company size
51 - 200 Employees
Headquarters location
Novi, MI, US
Year founded
2007