... remote work flexibility, but the selected candidate must reside in Nebraska. Opportunity for a Registered Nurse who has a US license in good standing to join our Medicaid Team as a Clinical Auditor.
... remote work flexibility, but the selected candidate must reside in Nebraska. Opportunity for a Registered Nurse who has a US license in good standing to join our Medicaid Team as a Clinical Auditor.
(RN)Auditor, Healthcare Services - NCQA
Long Beach, CA · On-site +1
$29.05 - $56.64/hr
... Registered Nurse (RN). License must be active and restricted in state of practice. • Strong ... Preferred Qualifications Prior experience in clinical review/auditing of care management.
(RN)Auditor, Healthcare Services - NCQA
Long Beach, CA · On-site +1
$29.05 - $56.64/hr
... Registered Nurse (RN). License must be active and restricted in state of practice. • Strong ... Preferred Qualifications Prior experience in clinical review/auditing of care management.
Auditor, Healthcare Services (RN) (Remote) Must Live In Nebraska
Long Beach, CA · Remote
$27.59 - $56.63/hr
... remote work flexibility, but the selected candidate must reside in Nebraska. Opportunity for a Registered Nurse who has a US license in good standing to join our Medicaid Team as a Clinical Auditor.
Auditor, Healthcare Services (RN) (Remote) Must Live In Nebraska
Long Beach, CA · Remote
$27.59 - $56.63/hr
... remote work flexibility, but the selected candidate must reside in Nebraska. Opportunity for a Registered Nurse who has a US license in good standing to join our Medicaid Team as a Clinical Auditor.
Auditor, Healthcare Services (RN) (Remote) Must Live In Nebraska
Long Beach, CA · On-site +1
$27.59 - $56.63/hr
... remote work flexibility, but the selected candidate must reside in Nebraska. Opportunity for a Registered Nurse who has a US license in good standing to join our Medicaid Team as a Clinical Auditor.
Auditor, Healthcare Services (RN) (Remote) Must Live In Nebraska
Long Beach, CA · On-site +1
$27.59 - $56.63/hr
... remote work flexibility, but the selected candidate must reside in Nebraska. Opportunity for a Registered Nurse who has a US license in good standing to join our Medicaid Team as a Clinical Auditor.
Auditor, Clinical Services
Long Beach, CA · On-site +1
$29.05 - $56.64/hr
... Registered Nurse (RN). License must be active and restricted in state of practice. • Strong ... auditing experience. #PJCorp3 #LI-AC1 To all current Molina employees: If you are interested in ...
Auditor, Clinical Services
Long Beach, CA · On-site +1
$29.05 - $56.64/hr
... Registered Nurse (RN). License must be active and restricted in state of practice. • Strong ... auditing experience. #PJCorp3 #LI-AC1 To all current Molina employees: If you are interested in ...
Auditor, Clinical Services
Long Beach, CA · On-site +1
$29.05 - $56.64/hr
... Registered Nurse (RN). License must be active and restricted in state of practice. • Strong ... auditing experience. #PJCorp #LI-AC1 To all current Molina employees: If you are interested in ...
Auditor, Clinical Services
Long Beach, CA · On-site +1
$29.05 - $56.64/hr
... Registered Nurse (RN). License must be active and restricted in state of practice. • Strong ... auditing experience. #PJCorp #LI-AC1 To all current Molina employees: If you are interested in ...
Auditor, Clinical Services
Long Beach, CA · On-site +1
$29.05 - $56.64/hr
... Registered Nurse (RN). License must be active and restricted in state of practice. • Strong ... auditing experience. #PJCorp #LI-AC1 To all current Molina employees: If you are interested in ...
Auditor, Clinical Services
Long Beach, CA · On-site +1
$29.05 - $56.64/hr
... Registered Nurse (RN). License must be active and restricted in state of practice. • Strong ... auditing experience. #PJCorp #LI-AC1 To all current Molina employees: If you are interested in ...
RN Clinical Documentation Integrity Specialist - Remote
Temecula, CA · On-site +1
$93K - $134K/yr
Southwest Healthcare is seeking a Full-Time Remote RN Clinical Documentation Integrity Specialist position. This position provides clinically based concurrent and retrospective review of inpatient ...
RN Clinical Documentation Integrity Specialist - Remote
Temecula, CA · On-site +1
$93K - $134K/yr
Southwest Healthcare is seeking a Full-Time Remote RN Clinical Documentation Integrity Specialist position. This position provides clinically based concurrent and retrospective review of inpatient ...
Lead, Medical Review Nurse (RN) Remote
Long Beach, CA · On-site +1
$28.76 - $62.30/hr
... auditing rules within software components to meet CMS regulatory mandates. • Utilizes Molina ... • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ...
Lead, Medical Review Nurse (RN) Remote
Long Beach, CA · On-site +1
$28.76 - $62.30/hr
... auditing rules within software components to meet CMS regulatory mandates. • Utilizes Molina ... • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ...
Lead, Medical Review Nurse (RN) Remote
Long Beach, CA · Remote
$37 - $50.25/hr
Supports the development of auditing rules within software components to meet CMS regulatory ... Registered Nurse (RN). License must be active and unrestricted in state of practice. Requires ...
Lead, Medical Review Nurse (RN) Remote
Long Beach, CA · Remote
$37 - $50.25/hr
Supports the development of auditing rules within software components to meet CMS regulatory ... Registered Nurse (RN). License must be active and unrestricted in state of practice. Requires ...
Remote Schedule: Varied hours with some weekend requirement Hospice Experience Required* Home Care ... Are you a compassionate and experienced RN who thrives on providing calm, confident support during ...
Remote Schedule: Varied hours with some weekend requirement Hospice Experience Required* Home Care ... Are you a compassionate and experienced RN who thrives on providing calm, confident support during ...
Hold an active RN license in the NLC compact states required * Hold an active license in the state of Minnesota and Nevada required What You\'ll Love about Nice: * 100% remote work environment
Hold an active RN license in the NLC compact states required * Hold an active license in the state of Minnesota and Nevada required What You\'ll Love about Nice: * 100% remote work environment
Registered Nurse - Clinical Documentation
San Francisco, CA · Remote
$60 - $80/hr
Registered Nurses (Data labelling and training) Type: Contract Compensation: $60-$80/hour Location ... Remote Role Responsibilities * Review and assess clinical documentation for accuracy, completeness ...
Quick apply
Registered Nurse - Clinical Documentation
San Francisco, CA · Remote
$60 - $80/hr
Registered Nurses (Data labelling and training) Type: Contract Compensation: $60-$80/hour Location ... Remote Role Responsibilities * Review and assess clinical documentation for accuracy, completeness ...
Remote Nurse Navigator (Registered Nurse)
Bodega Bay, CA · Remote
$140K - $160K/yr
Active RN license (any state) with 5+ years of clinical experience, ideally including surgical settings (ortho, spine, bariatric, cardiac, general surge) * Remote work experience -- must be ...
Quick apply
Remote Nurse Navigator (Registered Nurse)
Bodega Bay, CA · Remote
$140K - $160K/yr
Active RN license (any state) with 5+ years of clinical experience, ideally including surgical settings (ortho, spine, bariatric, cardiac, general surge) * Remote work experience -- must be ...
RN Case Manager
Los Angeles, CA · Remote
$85K/yr
RN Case Manager Remote (Full Time) Compensation: $85,000 About Us Zócalo Health is a tech-enabled, community-oriented primary care organization serving people who have historically been underserved ...
Quick apply
RN Case Manager
Los Angeles, CA · Remote
$85K/yr
RN Case Manager Remote (Full Time) Compensation: $85,000 About Us Zócalo Health is a tech-enabled, community-oriented primary care organization serving people who have historically been underserved ...
These are remote contract positions with extensive amount of travels (95-100%). You must live close ... AEA registered in OASIS is highly desirable * College degree AA or higher (or equivalent ...
These are remote contract positions with extensive amount of travels (95-100%). You must live close ... AEA registered in OASIS is highly desirable * College degree AA or higher (or equivalent ...
These are remote contract positions with extensive amount of travels (95-100%). You must live close ... AEA registered in OASIS is highly desirable * College degree AA or higher (or equivalent ...
These are remote contract positions with extensive amount of travels (95-100%). You must live close ... AEA registered in OASIS is highly desirable * College degree AA or higher (or equivalent ...
These are remote contract positions with extensive amount of travels (95-100%). You must live close ... AEA registered in OASIS is highly desirable * College degree AA or higher (or equivalent ...
These are remote contract positions with extensive amount of travels (95-100%). You must live close ... AEA registered in OASIS is highly desirable * College degree AA or higher (or equivalent ...
These are remote contract positions with extensive amount of travels (95-100%). You must live close ... AEA registered in OASIS is highly desirable * College degree AA or higher (or equivalent ...
These are remote contract positions with extensive amount of travels (95-100%). You must live close ... AEA registered in OASIS is highly desirable * College degree AA or higher (or equivalent ...
Remote Case Management RN - California License
San Bernardino, CA · On-site +1
$43 - $48/hr
Education/Licensure: - Active, valid, and unrestricted California RN license. Other Skills ... a remote setting. - Experience using standardized clinical guidelines. - Strong organizational ...
Remote Case Management RN - California License
San Bernardino, CA · On-site +1
$43 - $48/hr
Education/Licensure: - Active, valid, and unrestricted California RN license. Other Skills ... a remote setting. - Experience using standardized clinical guidelines. - Strong organizational ...
Remote Rn Auditor information
See California salary details
$19.45 - $21.87
6% of jobs
$21.87 - $24.28
6% of jobs
$24.28 - $26.70
3% of jobs
$28.25 is the 25th percentile. Wages below this are outliers.
$26.70 - $29.12
15% of jobs
$29.12 - $31.53
17% of jobs
The median wage is $31.86 / hr.
$31.53 - $33.95
23% of jobs
$34.81 is the 75th percentile. Wages above this are outliers.
$33.95 - $36.36
15% of jobs
$36.36 - $38.78
8% of jobs
$38.78 - $41.19
0% of jobs
$41.19 - $43.61
0% of jobs
$43.61 - $46.02
7% of jobs
$19
$32
$46
How much do remote rn auditor jobs pay per hour?
What is the difference between Remote Rn Auditor vs Remote Rn Reviewer?
| Aspect | Remote Rn Auditor | Remote Rn Reviewer |
|---|---|---|
| Certifications | RN license, auditing certifications (e.g., CHAP, RAC) | RN license, clinical review certifications |
| Work Environment | Healthcare organizations, insurance companies, auditing firms | Healthcare providers, insurance companies, utilization review |
| Primary Responsibilities | Auditing medical records for compliance, coding accuracy, and billing | Reviewing medical records for appropriateness and medical necessity |
Remote Rn Auditors focus on compliance and coding accuracy through audits, while Remote Rn Reviewers primarily assess medical necessity and appropriateness of care. Both roles require RN licensure and related certifications, often working within healthcare or insurance settings. The key difference lies in their core functions: auditing versus clinical review, though both contribute to quality and compliance in healthcare reimbursement.
What Does a Remote RN Auditor Do?
As a remote RN auditor, your job is to review claims and audit financial statements to ensure validity and accuracy. In this role, you may examine documentation from the patient or clinic, evaluate the effectiveness of care, or ensure that claims comply with government regulations. RN auditors often provide advice for cutting costs and contact both healthcare providers and clients to negotiate specific claims or resolve billing issues. Remote RN auditors often work with daily or weekly batches of work as assigned, but in rare cases, you may be asked to prioritize auditing certain material when time is of the essence.
Can you work remotely as an auditor?
What are the key skills and qualifications needed to thrive as a Remote RN Auditor, and why are they important?
How to make $300,000 as a nurse online?
What are some common challenges faced by Remote RN Auditors, and how can they be effectively managed?
What is the highest paying remote nurse job?
What is a Remote RN Auditor?
How do you become a nurse auditor?

Auditor, Healthcare Services (RN) (Remote) Must Live In Nebraska
Long Beach, CA • Remote
Full-time
Re-posted yesterday
Molina Healthcare rating
8.1
Based on 193 frontline employees who took The Breakroom Quiz
134th of 281 rated insurance
Job description
JOB DESCRIPTION
This position will offer remote work flexibility, but the selected candidate must reside in Nebraska.
Opportunity for a Registered Nurse who has a US license in good standing to join our Medicaid Team as a Clinical Auditor. The person filling this role will be an instrumental part of the team work to align the Medicaid Team compliance guidelines with those followed by our corporate teams. Knowledge and experience working with NCQA standards is vital to success in this role. The preferred candidate will have 3 - 5 years of experience in a MCO and at least 2 years of clinical auditing and/or review experience. Mastery of Microsoft Office, especially Excel, PowerPoint will also be skill sets we are seeking. Hours are Monday - Friday, 8AM - 5PM in your time zone.
Job Summary
Provides support for healthcare services clinical auditing activities. Performs audits for clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
Performs audits in care management, member assessment, behavioral health, and/or other clinical teams, and monitors clinical staff for compliance with National Committee for Quality Assurance, Centers for Medicare and Medicaid Services (CMS), and state/federal guidelines and requirements. May also perform non-clinical system and process audits as needed.
Audits for clinical gaps in care from a medical and/or behavioral health perspective to ensure member needs are being met.
Assesses clinical staff regarding appropriate clinical decision-making.
Reports monthly outcomes, identifies areas of re-training for staff, and communicates findings to leadership.
Ensures auditing approaches follow a Molina standard in approach and tool use.
Maintains member/provider confidentiality in compliance with the Health Insurance Portability and Accountability Act (HIPAA), and professionalism in all communications.
Adheres to departmental standards, policies and protocols.
Maintains detailed records of auditing results.
Assists healthcare services training team with developing training materials or job aids as needed to address findings in audit results.
Meets minimum production standards related to clinical auditing.
May conduct staff trainings as needed. Communicates with quality and/or healthcare services leadership regarding issues identified and works collaboratively to subsequently resolve/correct.
Required Qualifications
At least 2 years health care experience, with at least 1 year experience in care management, and/or managed care, or equivalent combination of relevant education and experience.
Registered Nurse (RN). License must be active and restricted in state of practice.
Strong attention to detail and organizational skills.
Strong analytical and problem-solving skills.
Ability to work in a cross-functional, professional environment.
Ability to work on a team and independently.
Excellent verbal and written communication skills.
Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
Care management, behavioral health and/or long-term services and supports (LTSS) clinical review/auditing experience.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
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About Molina Healthcare
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Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Long Beach, CA, US
Year founded
1980