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Remote Iqvia Rn Jobs in Washington, PA (NOW HIRING)

York Risk Services

RN Field Case Manager

Pittsburgh, PA · On-site +1

$75K - $96K/yr

... Insurance RN Field Case Manager This Field Case Manager will cover West Pittsburg, PA region ... remote work environment that allows face to face interaction with injured workers and medical ...

York Risk Services

RN Field Case Manager

Canonsburg, PA · On-site +1

$71K - $91K/yr

... Insurance RN Field Case Manager This Field Case Manager will cover West Pittsburg, PA region ... remote work environment that allows face to face interaction with injured workers and medical ...

Sedgwick

RN Field Case Manager

Pittsburgh, PA · On-site +1

$75K - $96K/yr

... Insurance RN Field Case Manager This Field Case Manager will cover West Pittsburg, PA region ... remote work environment that allows face to face interaction with injured workers and medical ...

Sedgwick

RN Field Case Manager

Canonsburg, PA · On-site +1

$71K - $91K/yr

... Insurance RN Field Case Manager This Field Case Manager will cover West Pittsburg, PA region ... remote work environment that allows face to face interaction with injured workers and medical ...

All JobsIqvia Rn JobsRemote Iqvia Rn JobsRemote Iqvia Rn Jobs in Washington, PA

Remote Iqvia Rn information

What is a Remote IQVIA RN?

A Remote IQVIA RN is a registered nurse who works for IQVIA, a global healthcare and clinical research company, providing nursing services remotely, often from home. These nurses may support clinical trials, conduct virtual patient assessments, educate patients, and help manage clinical data. Their work typically involves collaborating with clinical teams and using digital platforms to ensure high-quality patient care and compliance with study protocols. Remote IQVIA RNs play a crucial role in advancing medical research and supporting patient outcomes from a distance.

What are the key skills and qualifications needed to thrive as a Remote IQVIA RN?

To thrive as a Remote IQVIA RN, you need an active RN license, strong clinical judgment, and experience in patient care, often with a background in case management or clinical research. Familiarity with telehealth platforms, electronic data capture systems, and compliance with HIPAA regulations is typically required. Outstanding communication, self-motivation, and organizational skills help you excel in a remote environment while supporting patients and collaborating with teams. These skills are crucial for ensuring accurate patient assessments, regulatory compliance, and high-quality care delivery from a distance.

What are some common challenges faced by Remote IQVIA RNs, and how can they be addressed?

Remote IQVIA RNs often encounter challenges such as maintaining effective communication with clinical teams, managing time zones, and staying updated on electronic documentation requirements. Adapting to virtual collaboration tools and prioritizing tasks independently are essential. Regular check-ins with team members and utilizing IQVIA’s robust support resources can help Remote RNs stay connected and efficient, ensuring high-quality patient care and smooth workflow.

What is the difference between Remote Iqvia Rn vs Remote Medical Coder?

AspectRemote Iqvia RnRemote Medical Coder
CredentialsRegistered Nurse (RN) licenseCertification in medical coding (CPC, CCS)
Work EnvironmentHealthcare settings, clinical data reviewMedical records coding, billing departments
Industry UsagePharmaceutical, clinical research, healthcare

Remote Iqvia Rn and Remote Medical Coder roles both operate in healthcare but focus on different tasks. RNs handle patient care and clinical data, while Medical Coders focus on translating medical records into codes for billing. Both require specialized certifications and are common in healthcare and research industries.

What are popular job titles related to Remote Iqvia Rn jobs in Washington, PA?

For Remote Iqvia Rn jobs in Washington, PA, the most frequently searched job titles are:

What job categories do people searching Remote Iqvia Rn jobs in Washington, PA look for?

The top searched job categories for Remote Iqvia Rn jobs in Washington, PA are:

What cities near Washington, PA are hiring for Remote Iqvia Rn jobs?

Cities near Washington, PA with the most Remote Iqvia Rn job openings:

Remote Iqvia Rn jobs near you
Infographic showing various Remote Iqvia Rn job openings in Washington, PA as of August 2026, with employment types broken down into 66% Full Time, 22% Part Time, and 12% Contract. Highlights an 100% Remote job distribution.

Remote/Hybrid Registered Nurse (RN) - Advocacy & Program Integrity (Medical Assistance Expert)

The CKHobbie Group

Pittsburgh, PA • On-site, Remote

$40 - $42/hr

Full-time

PTO

Re-posted 5 days ago

Job description


Are you a registered nurse ready to take your career in an exciting newdirection-one where your expertise truly makes a difference? JoinPennsylvania's premier Quality Improvement Organization and step into adynamic role focused on advocacy and program integrity through compliance management. Here, you'll champion the needs of vulnerable populations,safeguard the quality of care, and influence healthcare outcomes on ameaningful scale. Enjoy the freedom of working from home, theflexibility and autonomy to manage your workday, and the opportunity forcontinuous professional growth-all while being part of a passionate,mission-driven team dedicated to improving healthcare across theCommonwealth.
In this rewarding role, you'll use your clinical knowledge outside ofthe traditional bedside setting to review and audit claims, supportprogram integrity initiatives, and advocate for beneficiaries across theCommonwealth. You'll enjoy the flexibility of working from home, theautonomy to manage your work, and meaningful opportunities forprofessional growth-all while contributing to a mission that trulymatters.
What You'll Do
  • Conduct clinical reviews and ensure quality, appropriateness, and compliance with healthcare standards
  • Support program integrity efforts by identifying trends, risks, and opportunities for improvement
  • Advocate for beneficiaries, with a strong focus on protecting and improving care for vulnerable populations
  • Apply nursing judgment to analyze medical records, documentation, and billing data
  • Collaborate with interdisciplinary teams, providers, and stakeholders to promote best practices
  • Contribute to quality improvement initiatives that strengthen healthcare delivery across Pennsylvania

What We're Looking For
  • Active, unrestricted Registered Nurse (RN) license
  • Strong clinical background with the ability to apply nursing judgment analytically
  • Interest in advocacy, quality improvement, and healthcare program integrity
  • Excellent written and verbal communication skills
  • Ability to work independently while managing multiple priorities
  • Comfort with technology and electronic medical records

Experience in utilization review, case management, quality improvement, compliance, or claims review is a plus-but not required.
Why Join Us
  • Mission-driven work with Pennsylvania's leading Quality Improvement Organization
  • Make a real impact on healthcare quality and outcomes for vulnerable populations
  • Remote work - enjoy the convenience and balance of working from home
  • Autonomy and flexibility in how you manage your workday
  • Advocacy-focused role that values your nursing voice and expertise
  • Career development opportunities to grow beyond traditional nursing roles
  • Supportive, collaborative team culture committed to excellence and integrity

If you're a registered nurse seeking purpose-driven work,professional growth, and the flexibility to balance your life andcareer-this is your opportunity. Apply today and help shape the future of healthcare quality in Pennsylvania.
Requirements
Be available as a full-time consultant, approximately 37.5 hours per week;
• Possess a current license to practice as a Registered Nurse issued by the Pennsylvania
State Board of Nursing; or possess a non-renewable temporary practice permit issued
by the Pennsylvania State Board of Nursing. Resources possessing non-renewable
temporary practice permits must obtain licensing as a Registered Nurse within the
one-year period as defined by the Pennsylvania State Board of Nursing;
• Possess a documented work history of three (3) or more years of professional
experience with medical assistance, health care services or human services or any
equivalent combination of experience and training;
• Possess basic computer skills, including familiarity with Microsoft Office programs.
Principal Duties and Responsibilities (RN - Utilization Review / Program Integrity)
  • Conduct clinical utilization reviews by evaluating medical records, treatment plans, and supporting documentation to determine medical necessity, appropriateness, quality, and level of care in accordance with Medical Assistance (MA) program requirements.
  • Apply nursing judgment and evidence-based clinical standards to ensure MA recipients receive safe, appropriate, and high-quality care while supporting program integrity and regulatory compliance.
  • Assess provider billing and documentation to verify compliance with MA policies and identify potential fraud, waste, or abuse.
  • Review clinical documentation submitted through electronic provider portals, telephone communications, fax, and U.S. mail, ensuring completeness and accuracy for utilization determinations.
  • Make authorization determinations by approving, modifying, or denying service requests within RN scope of practice, or refer cases to physician advisors for secondary medical review when medical necessity or level of care is unclear.
  • Collaborate with physician/medical consultants to support peer-to-peer reviews and facilitate discussions with ordering providers regarding clinical justification, appropriate care settings, and service coverage.
  • Accurately document utilization review decisions and clinical rationale in electronic systems, generating authorization notices, denial letters, reason codes, and appeal rights in compliance with regulatory standards.
  • Participate in retrospective, concurrent, and prospective utilization reviews, including re-evaluations of previously denied services upon request by providers or facilities.
  • Review and prepare appeal cases by analyzing medical records, developing exhibits and correspondence, and providing testimony at administrative hearings using knowledge of MA regulations, utilization management principles, and appeal processes.
  • Interpret MA policies, regulations, and utilization management guidelines for internal staff, providers, and stakeholders through consultation, meetings, and educational sessions.
  • Engage in interdisciplinary collaboration with internal departments, medical consultants, legal staff, and external stakeholders to support consistent and defensible utilization determinations.
  • Maintain ongoing professional development through continuing education, conferences, and review of current medical literature to remain current with standards of care, clinical guidelines, and utilization review best practices.
  • Provide cross-coverage in other program areas as needed, maintaining competency through training and updates to ensure continuity of program operations.
  • Respond to inquiries from recipients, providers, legislators, legal offices, and external agencies to explain utilization decisions, coverage policies, and administrative processes.
  • Maintain accurate case records and documentation in accordance with MA regulations, accreditation standards, and organizational policies.
  • Perform related duties and special projects as assigned, with expectations and performance standards communicated for each assignment.
  • When required, work at Department-designated locations. The primary duty location is Pittsburgh, PA, where appropriate workspace, technology, and resources will be provided to support assigned responsibilities.

Benefits
Attractive Compensation plan.Holiday and Vacation program.

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