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Remote Rn Case Review Jobs in Louisiana (NOW HIRING)

Appeals Pharmacist (Remote)

Baton Rouge, LA · On-site +1

$50 - $61/hr

Collaborate with physicians, nurses, and medical directors during case reviews. * Track, document ... Many roles offer hybrid or fully remote options. * Rewards: Competitive salary, comprehensive ...

Home Infusion RN Per Diem Company: Atulo Health About Atulo Health: Atulo Health is a multi-state provider of home infusion services. We deliver high-quality, patient-centered care using smart ...

Home Infusion RN Per Diem Company: Atulo Health About Atulo Health: Atulo Health is a multi-state provider of home infusion services. We deliver high-quality, patient-centered care using smart ...

PRN Home Infusion RN

Schriever, LA · Remote

$40 - $50/hr

Home Infusion RN Per Diem Company: Atulo Health About Atulo Health: Atulo Health is a multi-state provider of home infusion services. We deliver high-quality, patient-centered care using smart ...

Home Infusion RN - Per Diem Company: Atulo Health About Atulo Health: Atulo Health is a multi-state provider of home infusion services. We deliver high-quality, patient-centered care using smart ...

Home Infusion RN Per Diem Company: Atulo Health About Atulo Health: Atulo Health is a multi-state provider of home infusion services. We deliver high-quality, patient-centered care using smart ...

Home Infusion RN - Per Diem Company: Atulo Health About Atulo Health: Atulo Health is a multi-state provider of home infusion services. We deliver high-quality, patient-centered care using smart ...

$10/hr

Current COMPACT license to practice as an RN/ LVN/LPN held in current state of residence with no ... A minimum of two (2) years of clinical experience in a Med/Surg, Case Management, and/or home ...

Certification in Case Management * Motivational Interviewing Certification or knowledge Workstyle ... Combination remote work at home and onsite/home member visits Hours: We require the ability to work ...

Certification in Case Management * Motivational Interviewing Certification or knowledge Workstyle ... Combination remote work at home and onsite/home member visits Hours: We require the ability to work ...

Certification in Case Management * Motivational Interviewing Certification or knowledge Workstyle ... Combination remote work at home and onsite/home member visits Hours: We require the ability to work ...

Certification in Case Management * Motivational Interviewing Certification or knowledge Workstyle ... Combination remote work at home and onsite/home member visits Hours: We require the ability to work ...

Certification in Case Management * Motivational Interviewing Certification or knowledge Workstyle ... Combination remote work at home and onsite/home member visits Hours: We require the ability to work ...

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Showing results 1-20

Remote Rn Case Review information

What is the difference between Remote Rn Case Review vs Remote Rn Utilization Review?

AspectRemote Rn Case ReviewRemote Rn Utilization Review
CredentialsRegistered Nurse (RN), licensure, case review certificationsRegistered Nurse (RN), licensure, utilization review certifications
Work EnvironmentRemote, healthcare settings, insurance companiesRemote, healthcare settings, insurance companies
Employer & IndustryHospitals, insurance firms, healthcare providersInsurance companies, healthcare management organizations

Remote Rn Case Review and Remote Rn Utilization Review roles both involve remote nursing work within the healthcare and insurance industries. While they share similar credentials and work environments, case review focuses on evaluating individual patient cases, whereas utilization review assesses the necessity and appropriateness of healthcare services. Understanding these distinctions helps job seekers identify the right role based on their skills and career goals.

What cities in Louisiana are hiring for Remote Rn Case Review jobs? Cities in Louisiana with the most Remote Rn Case Review job openings:
QA/QC Manager - Human Services Program - Baton Rouge, LA Remote

QA/QC Manager - Human Services Program - Baton Rouge, LA Remote

The Workforce Group

Baton Rouge, LA • Remote

$47 - $50/hr

Full-time

Posted 6 days ago


Job description

Summary: The Workforce Group, a LEMOINE company, is seeking an experienced QA/QC Manager to support a federal human services program serving vulnerable populations, including youth, young adults, and families. The QA/QC Manager is responsible for developing, implementing, and maintaining quality control processes that support accurate case documentation, timely case progression, compliant reporting, corrective action tracking, and continuous improvement. This role reviews operational performance, conducts internal audits, monitors documentation quality, identifies trends or deficiencies, and works with program leadership to ensure work products meet program standards and client requirements. This position requires strong quality assurance experience, excellent documentation skills, attention to detail, data analysis capability, confidentiality, and the ability to work across field operations, case coordination, data, reporting, training, onboarding, and program leadership teams.


Location: Remote

Travel: Limited travel may be required for training, meetings, surge support, or operational coverage.

Duties and Responsibilities:

  • Develop, implement, and maintain the program’s internal quality control processes, review standards, audit tools, and documentation checklists.
  • Support implementation of the program quality control plan and related operating procedures.
  • Conduct quality reviews of case documentation, field visit records, research notes, contact notes, data entries, reports, and supporting documentation.
  • Review case records for accuracy, completeness, timeliness, consistency, and required documentation.
  • Identify documentation gaps, late actions, inconsistent information, incomplete case files, duplicate entries, and quality trends.
  • Monitor program performance metrics related to case timeliness, case accuracy, documentation quality, staff readiness, deliverables, incident escalation, and background/onboarding package completion.
  • Conduct routine internal audits and targeted reviews based on risk, volume, deadlines, case status, or leadership direction.
  • Document audit findings, quality trends, causes, corrective actions, and follow-up results.
  • Develop and maintain corrective action trackers and ensure assigned corrective actions are completed.
  • Coordinate with field operations, case research, case coordination, data/reporting, training, onboarding, and program leadership teams to resolve quality issues.
  • Support readiness reviews for case files before final submission, closure, reporting, or invoice support.
  • Review incident and escalation documentation for completeness, timeliness, and required follow-up.
  • Support training and coaching by identifying recurring documentation or performance issues.
  • Prepare quality reports, dashboards, summaries, trend analyses, and briefing materials for program leadership.
  • Maintain organized quality records, audit files, review logs, corrective action documentation, and quality-control evidence.
  • Ensure sensitive participant, program, and Government-related information is protected and handled appropriately.
  • Participate in operational briefings, quality meetings, staff meetings, training sessions, and continuous-improvement activities.
  • Perform additional duties as assigned.

Qualifications, Knowledge, Skills, and Abilities: High school diploma or equivalent required.Associate or bachelor’s degree in human services, social work, criminal justice, psychology, sociology, public administration, business administration, emergency management, quality management, data management, or a related field. Minimum of three years (3) of experience in quality assurance, quality control, compliance, auditing, case review, documentation review, human services operations, federal program support, field operations support, or related work preferred.

  • Experience reviewing case files, reports, documentation, data entries, or operational records for accuracy and completeness.
  • Strong attention to detail and ability to identify documentation gaps, inconsistencies, trends, and quality risks.
  • Ability to develop and maintain checklists, trackers, audit logs, corrective action plans, and quality reports.
  • Strong written and verbal communication skills.
  • Ability to prepare clear, accurate, objective, and timely quality documentation.
  • Ability to work independently and exercise sound judgment in a fast-paced, deadline-driven environment.
  • Ability to maintain confidentiality, professional boundaries, and ethical standards at all times.
  • Proficiency with Microsoft Office, Excel, Word, PowerPoint, Teams, email, shared trackers, databases, and electronic documentation systems.
  • Ability to learn and use approved case management, reporting, dashboard, or quality review tools.
  • Ability to complete required federal, client, and company training before beginning work.
  • Ability to complete required pre-employment screening and federal background/suitability processing.
  • Experience supporting federal, state, or local government programs.
  • Experience supporting human services, vulnerable populations, youth, young adults, families, immigrant communities, emergency response, disaster recovery, or field-based operations.
  • Experience with quality assurance plans, corrective action plans, root cause analysis, performance metrics, dashboards, audit sampling, or internal compliance reviews.
  • Experience reviewing records for timeliness, accuracy, completeness, and documentation sufficiency.
  • Experience working with geographically dispersed teams or field-based operations.
  • Strong Excel skills, including sorting, filtering, pivot tables, tracking logs, and quality dashboards.
  • Bilingual English/Spanish preferred.
  • Must be authorized to work in the United States.
Work Environment and Schedule

This position is primarily remote/or operations hub-based and requires regular use of computers, secure systems, phones, email, spreadsheets, and electronic documentation tools. The role supports deadline-driven operations and requires accuracy, confidentiality, responsiveness, and consistent communication with multiple teams.The schedule may vary based on operational needs, case volume, quality review requirements, reporting deadlines, and surge activity. Evening, weekends, holiday, extended-hour, or surge support may be required. Limited travel may be required for training, audits, meetings, or operational coverage.


Federal Contract Requirements

Employment is contingent upon successful completion of all pre-employment screening requirements, including background checks, drug screening, motor vehicle records review, reference checks and other job-related screening requirements. Employment is also contingent upon successful completion of required federal background/suitability review, favorable credit check, security processing, and program-specific onboarding before beginning work.

Employees assigned to this program must complete required training, protect sensitive information, comply with standards of conduct, maintain professional boundaries, and follow all reporting, confidentiality, privacy, and information security requirements. Employees may be required to sign confidentiality, non-disclosure, conflict-of-interest, and standards-of-conduct acknowledgments.

ABOUT US

The Workforce Group a LEMOINE company is a Great Place to Work® Certified company. We are a team of dedicated professionals that pull together to meet the needs of communities partnering with federal, state, and local governments.