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Remote Clinical Reviewer Jobs in Rhode Island (NOW HIRING)

Pharmacist

Woonsocket, RI ยท On-site +1

$55.75 - $67/hr

Fully remote (never coming onsite) Position Summary The Pharmacist/Clinician is an operation-based role that conducts criteria based & clinical review of medical data collected to perform prior ...

DSNP Clinical Pharmacist

Providence, RI ยท On-site +1

$116K - $187K/yr

It's why we offer flexible work arrangements that include remote and hybrid opportunities and paid ... Review prescriptions issued by physician or other authorized prescriber to ensure appropriateness ...

... clinical autonomy. What You'll Do * Conduct virtual consultations with pet parents via video and ... Review medical history, symptoms, and treatment concerns shared through Dutch's digital platform

... clinical autonomy. What You'll Do * Conduct virtual consultations with pet parents via video and ... Review medical history, symptoms, and treatment concerns shared through Dutch's digital platform

... clinical autonomy. What You'll Do * Conduct virtual consultations with pet parents via video and ... Review medical history, symptoms, and treatment concerns shared through Dutch's digital platform

Provides thorough clinical review or benefit analysis to determine if the requested services meet ... This is a full-time position (40 hours per week), working Monday through Friday in a fully remote ...

Chart Review: 8 min Outreach Attempts: 6 min Actual Call: 11 min Care Coordination: 9 min Total ... A minimum of two (2) years of clinical experience - preferably in pain management * Hands-on ...

Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... Author and review evaluation tasks based on DSURs, PSURs/PBRERs, and associated safety data and ...

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Remote Clinical Reviewer information

See Rhode Island salary details

$23

$35

$45

How much do remote clinical reviewer jobs pay per hour?

As of Sep 8, 2026, the average hourly pay for remote clinical reviewer in Rhode Island is $35.17, according to ZipRecruiter salary data. Most workers in this role earn between $30.62 and $39.57 per hour, depending on experience, location, and employer.

What is a remote clinical reviewer?

Remote Clinical Reviewers are healthcare professionals, often nurses or physicians, who evaluate medical records and treatment plans from a remote location to ensure they meet clinical guidelines and insurance requirements. They assess the necessity, appropriateness, and quality of care provided to patients, often working for insurance companies, healthcare organizations, or third-party review agencies. This role typically involves reviewing documentation, making recommendations, and communicating findings electronically or by phone. The position allows for flexible, home-based work while contributing to healthcare quality and compliance.

What does a remote clinical reviewer do?

A remote clinical reviewer works from home reviewing medical records and claims for inpatient and outpatient services. Your responsibilities include executing a thorough review of patient medical records, submitting documentation to insurance companies, and ensuring accurate, timely, and secure processing of patient information. As a clinical reviewer, your duties span determining coverage for diagnosis and treatment, reviewing appeals, and processing correspondence. You provide remote support and expertise to department care coordinators, interact with teams and department heads as necessary, and request additional information for processing records as necessary.

What are the key skills and qualifications needed to thrive as a remote clinical reviewer, and why are they important?

To thrive as a Remote Clinical Reviewer, you need a healthcare background such as RN, LPN, or other clinical licensure, along with strong knowledge of medical guidelines and utilization review processes. Familiarity with electronic medical record (EMR) systems, medical coding, and utilization management software is typically required. Attention to detail, analytical thinking, and clear written communication are crucial soft skills for reviewing patient cases and collaborating with remote teams. These skills and qualifications ensure accurate and timely clinical assessments, support compliance, and help facilitate appropriate patient care decisions in a virtual environment.

How does a remote clinical reviewer typically collaborate with other healthcare professionals while working offsite?

Remote Clinical Reviewers regularly coordinate with physicians, nurses, and case managers through secure digital platforms, such as video conferencing, email, and electronic health record systems. Despite working remotely, they are integral to interdisciplinary teams and often participate in virtual meetings to discuss patient cases, clarify documentation, and ensure compliance with clinical guidelines. Building strong communication skills and familiarity with collaboration tools is essential for success in this role, as frequent interaction with both internal teams and external providers is a common aspect of daily responsibilities.

What is the difference between Remote Clinical Reviewer vs Remote Medical Reviewer?

AspectRemote Clinical ReviewerRemote Medical Reviewer
Required CredentialsRN, LPN, or other healthcare licenses; clinical experienceMD or DO license; medical degree; clinical experience
Work EnvironmentHome-based, healthcare organizations, insurance companiesHome-based, insurance companies, healthcare organizations
Employer & Industry UsageInsurance, healthcare providers, government programsInsurance, healthcare, legal medical review
Common Search & ComparisonYesYes

Remote Clinical Reviewers typically hold nursing or healthcare licenses and focus on reviewing clinical documentation and patient care. Remote Medical Reviewers usually have medical degrees and perform in-depth medical assessments, often for insurance claims or legal cases. Both roles are home-based and serve similar industries, but the Medical Reviewer requires a medical degree and broader clinical expertise.

What are popular job titles related to Remote Clinical Reviewer jobs in Rhode Island?

For Remote Clinical Reviewer jobs in Rhode Island, the most frequently searched job titles are:

What job categories do people searching Remote Clinical Reviewer jobs in Rhode Island look for?

The top searched job categories for Remote Clinical Reviewer jobs in Rhode Island are:

What cities in Rhode Island are hiring for Remote Clinical Reviewer jobs?

Cities in Rhode Island with the most Remote Clinical Reviewer job openings:

Infographic showing various Remote Clinical Reviewer job openings in Rhode Island as of August 2026, with employment types broken down into 4% As Needed, 70% Full Time, 18% Part Time, and 8% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $73,161 per year, or $35.2 per hour.

Remote Clinical Support Nurse (RN or LPN)

HealthDrive

Providence, RI โ€ข Remote

Full-time

Posted 5 days ago


Job description

Overview

We are seeking a highly skilled RN or LPN to serve as the remote support hub for our in-house Nurse Practitioners (NPs) practicing in Skilled Nursing Facilities (SNFs) as a Remote Clinical Support Nurse.

The Clinical Support Nurse coordinates care for high-risk residents in SNF and ALF settings. This role partners with physicians, nurse practitioners, nursing leaders, residents, families, specialists, pharmacies, and community providers to prioritize clinical needs, close communication gaps, and support safe transitions of care.

Role Scope

  • Post-acute and long-term care residents in SNF/ALF settings.
  • Daily clinical navigation from admission through discharge.
  • Close collaboration with facility and provider teams.

Primary Objectives

  • Surface risk early: Review clinical information and direct provider attention to residents with the greatest needs.
  • Close care gaps: Track consultations, laboratory results, orders, records, medications, and follow-up activities through completion.
  • Prepare the care team: Coordinate schedules and pre-chart relevant information for efficient, informed visits.
  • Keep people connected: Provide routine updates and promptly escalate acute, complex, or change-of-status concerns.

Why You'll Love This Role

  • High Visibility & Strategic Impact: This role isn't just a support function; you'll be a key partner in building, refining, and scaling this program, with a direct line to company leadership.
  • True Work-Life Balance: This is a fully remote, Work-From-Home position with the flexibility to manage your own schedule and day.
  • Be a Pioneer: You get to be on the ground floor of a high-impact program. You'll help create the playbook, refine workflows, and have a tangible impact on the program's success as it scales.
  • Meaningful Growth: We are committed to your professional development, with opportunities to expand your licensure and grow alongside the program.

HealthDrive delivers on-site dentistry, optometry, podiatry, audiology, behavioral health, and primary care services to residents in long-term care, skilled nursing, and assisted living facilities. Each specialty offered by HealthDrive is one that directly impacts the quality of daily life for the deserving residents we serve. HealthDrive connects patients in need of vital healthcare to doctors committed to dignity and excellence.


Responsibilities

  • Clinical Review and Provider Readiness

    • Review overnight nursing logs, emergency-department notices, clinical records, and daily risk reports to identify instability and prioritize high-risk residents.
    • Build and maintain provider schedules for high-risk residents, new admissions, planned discharges, regulatory visits, and follow-up care.
    • Pre-chart diagnoses, functional status, recent events, laboratory results, medications, consultation findings, and outstanding actions.

    Consultations and Clinical Follow-Through

    • Coordinate specialist appointments, transportation, communication, and receipt of consultation notes.
    • Track consultant recommendations and promptly route therapy, procedure, or order changes to the physician, nurse practitioner, and facility team.
    • Retrieve and integrate HIE information, emergency-visit records, discharge summaries, outside consultations, laboratory results, and other provider records into the appropriate clinical system.

    MDS/PDPM Coordination

    • Partner with facility MDS coordinators to schedule provider visits and ensure functional and diagnostic conditions are comprehensively captured.
    • Prepare clinical information supporting accurate MDS/PDPM documentation without placing additional administrative burden on the rounding provider.

    Team Alignment and Documentation

    • Communicate with nursing leadership, unit managers, collaborating clinicians, and facility staff to clarify priorities and next steps.
    • Complete timely documentation and confirm that provider orders are entered into the facility EMR.
    • Coordinate controlled-substance renewal scheduling as assigned.

    Discharge and Community Transition

    • Coordinate discharge visits so provider assessments and documentation are completed before residents leave the facility.
    • Schedule timely community PCP follow-up appointments.
    • Communicate care plans, medications, and next steps to residents, families, pharmacies, and community partners.
    • Oversee prescription ordering and pharmacy fulfillment to support medication availability at home.

    Medication and Laboratory Safety

    • Reconcile facility, provider, and discharge medication lists and resolve discrepancies with the appropriate clinician.
    • Review medication lists for deprescribing opportunities and escalate concerns involving polypharmacy, side effects, or interactions.
    • Identify missing outside laboratory results and ensure they are available for clinical review.

    Resident and Family Communication

    • Provide proactive, compassionate updates regarding stable progress, routine results, therapy milestones, and transition plans.
    • Serve as a consistent point of contact for residents and families.
    • Promptly escalate acute changes, complex clinical questions, and sensitive conversations to the physician or nurse practitioner.

    Advance Care Planning Support

    • Identify residents experiencing clinical deterioration who may benefit from advanced care planning or palliative-care evaluation.
    • Coordinate with qualified providers on goals-of-care discussions, POLST documentation, symptom-management planning, and family education.

Qualifications

  • Active, unencumbered Nursing license in the applicable state or states of practice. Connecticut/Rhode Island/Compact Licensure
  • Clinical nursing experience in post-acute care, long-term care, geriatrics, transitions of care, or care management.
  • Strong clinical assessment, prioritization, medication reconciliation, documentation, and care-coordination skills.
  • Ability to use EMRs, HIEs, scheduling tools, and secure communication channels.
  • Working knowledge of MDS/PDPM, discharge planning, advance directives or POLST, privacy requirements, and professional scope of practice.