Omaha, NE · Remote
$90K - $110K/yr
... remote reimbursement, MDS, PDPM, Case Mix Index, and RAI support to our long-term care and skilled ... Review PDPM classifications, clinical documentation, diagnosis coding, and reimbursement accuracy
Quick apply
Omaha, NE · Remote
$90K - $110K/yr
... remote reimbursement, MDS, PDPM, Case Mix Index, and RAI support to our long-term care and skilled ... Review PDPM classifications, clinical documentation, diagnosis coding, and reimbursement accuracy
Hollidaysburg, PA · On-site +1
$70K - $113K/yr
Seeking PA licensed BH/RN candidates for this position supporting Blair County. This position is ... Audits and reviews case manager and provider clinical documentation and telephone interactions ...
New
Hollidaysburg, PA · On-site +1
$70K - $113K/yr
Seeking PA licensed BH/RN candidates for this position supporting Blair County. This position is ... Audits and reviews case manager and provider clinical documentation and telephone interactions ...
New
Omaha, NE · Remote
$63K - $95K/yr
This is a remote position, but all candidates must reside in one of the following states: NE, IA ... Current RN Licensure in state of operation * 3 or more years of recent clinical experience ...
Quick apply
Omaha, NE · Remote
$63K - $95K/yr
This is a remote position, but all candidates must reside in one of the following states: NE, IA ... Current RN Licensure in state of operation * 3 or more years of recent clinical experience ...
Omaha, NE · Remote
$63K - $95K/yr
This is a remote position, but all candidates must reside in one of the following states: NE, IA ... Current RN Licensure in state of operation * 3 or more years of recent clinical experience ...
Quick apply
Omaha, NE · Remote
$63K - $95K/yr
This is a remote position, but all candidates must reside in one of the following states: NE, IA ... Current RN Licensure in state of operation * 3 or more years of recent clinical experience ...
Omaha, NE · Remote
$63K - $95K/yr
This is a remote position, but all candidates must reside in one of the following states: NE, IA ... Current RN Licensure in state of operation * 3 or more years of recent clinical experience ...
Omaha, NE · Remote
$63K - $95K/yr
This is a remote position, but all candidates must reside in one of the following states: NE, IA ... Current RN Licensure in state of operation * 3 or more years of recent clinical experience ...
Omaha, NE · Remote
$63K - $95K/yr
This is a remote position, but all candidates must reside in one of the following states: NE, IA ... Current RN Licensure in state of operation * 3 or more years of recent clinical experience ...
Omaha, NE · Remote
$63K - $95K/yr
This is a remote position, but all candidates must reside in one of the following states: NE, IA ... Current RN Licensure in state of operation * 3 or more years of recent clinical experience ...
Lincoln, NE · Remote
$18 - $40/hr
... NCLEX case study formats. Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates ...
Lincoln, NE · Remote
$18 - $40/hr
... NCLEX case study formats. Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates ...
Omaha, NE · Remote
$18 - $40/hr
... NCLEX case study formats. Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates ...
Omaha, NE · Remote
$18 - $40/hr
... NCLEX case study formats. Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates ...
Reviews, assesses, and completes medical complexity attestations and clinical oversight activities ... Certification in Case Management * Motivational Interviewing Certification and/or knowledge ...
Reviews, assesses, and completes medical complexity attestations and clinical oversight activities ... Certification in Case Management * Motivational Interviewing Certification and/or knowledge ...
Reviews, assesses, and completes medical complexity attestations and clinical oversight activities ... Certification in Case Management * Motivational Interviewing Certification and/or knowledge ...
Reviews, assesses, and completes medical complexity attestations and clinical oversight activities ... Certification in Case Management * Motivational Interviewing Certification and/or knowledge ...
Reviews, assesses, and completes medical complexity attestations and clinical oversight activities ... Certification in Case Management * Motivational Interviewing Certification and/or knowledge ...
Reviews, assesses, and completes medical complexity attestations and clinical oversight activities ... Certification in Case Management * Motivational Interviewing Certification and/or knowledge ...
Omaha, NE · On-site +1
$95K - $152K/yr
... remote/telecommuting opportunity Position Summary Nurse Practitioner (NPs) specialist is a ... Initial application review will begin on the date provided in the field above. Applications ...
Omaha, NE · On-site +1
$95K - $152K/yr
... remote/telecommuting opportunity Position Summary Nurse Practitioner (NPs) specialist is a ... Initial application review will begin on the date provided in the field above. Applications ...
Lincoln, NE · Remote
$27.59 - $56.63/hr
... review experience. Mastery of Microsoft Office, especially Excel, PowerPoint will also be skill ... Registered Nurse (RN). License must be active and restricted in state of practice. Strong attention ...
Lincoln, NE · Remote
$27.59 - $56.63/hr
... review experience. Mastery of Microsoft Office, especially Excel, PowerPoint will also be skill ... Registered Nurse (RN). License must be active and restricted in state of practice. Strong attention ...
Lincoln, NE · Remote
$27.59 - $56.63/hr
... review experience. Mastery of Microsoft Office, especially Excel, PowerPoint will also be skill ... Registered Nurse (RN). License must be active and restricted in state of practice. • Strong ...
Lincoln, NE · Remote
$27.59 - $56.63/hr
... review experience. Mastery of Microsoft Office, especially Excel, PowerPoint will also be skill ... Registered Nurse (RN). License must be active and restricted in state of practice. • Strong ...
Omaha, NE · Remote
$27.59 - $56.63/hr
... review experience. Mastery of Microsoft Office, especially Excel, PowerPoint will also be skill ... Registered Nurse (RN). License must be active and restricted in state of practice. • Strong ...
Omaha, NE · Remote
$27.59 - $56.63/hr
... review experience. Mastery of Microsoft Office, especially Excel, PowerPoint will also be skill ... Registered Nurse (RN). License must be active and restricted in state of practice. • Strong ...
Essential Job Functions Responsible for providing remote nursing care to the patient and assistance ... Develop/review/revise and individualize the plan of care to address the patient's nursing care ...
Essential Job Functions Responsible for providing remote nursing care to the patient and assistance ... Develop/review/revise and individualize the plan of care to address the patient's nursing care ...
$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 ...
$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 ...
Omaha, NE · On-site +1
$57K - $85K/yr
Remote/Telecommuting No remote/telecommuting opportunity Position Summary To coordinate clinical ... Initial application review will begin on the date provided in the field above. Applications ...
Omaha, NE · On-site +1
$57K - $85K/yr
Remote/Telecommuting No remote/telecommuting opportunity Position Summary To coordinate clinical ... Initial application review will begin on the date provided in the field above. Applications ...
Omaha, NE · On-site +1
$73K - $110K/yr
... Remote/Telecommuting No remote/telecommuting opportunity Position Summary Responsible for ... Initial application review will begin on the date provided in the field above. Applications ...
Omaha, NE · On-site +1
$73K - $110K/yr
... Remote/Telecommuting No remote/telecommuting opportunity Position Summary Responsible for ... Initial application review will begin on the date provided in the field above. Applications ...
Omaha, NE · On-site +1
$64K - $96K/yr
... No remote/telecommuting opportunity Position Summary To coordinate clinical research for ... Initial application review will begin on the date provided in the field above. Applications ...
Omaha, NE · On-site +1
$64K - $96K/yr
... No remote/telecommuting opportunity Position Summary To coordinate clinical research for ... Initial application review will begin on the date provided in the field above. Applications ...
| Aspect | Remote Rn Case Review | Remote Rn Utilization Review |
|---|---|---|
| Credentials | Registered Nurse (RN), licensure, case review certifications | Registered Nurse (RN), licensure, utilization review certifications |
| Work Environment | Remote, healthcare settings, insurance companies | Remote, healthcare settings, insurance companies |
| Employer & Industry | Hospitals, insurance firms, healthcare providers | Insurance 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.
$90K - $110K/yr
Full-time
Re-posted 9 days ago
Are you ready to make a change?
We are seeking an experienced Regional MDS / PDPM / CMI / RAI Consultant to provide remote reimbursement, MDS, PDPM, Case Mix Index, and RAI support to our long-term care and skilled nursing facilities.
This position will provide regional oversight to ensure accurate MDS completion, proper PDPM classification, optimized reimbursement, accurate case mix, regulatory compliance, and strong interdisciplinary team processes. Quarterly travel to assigned facilities will be required for on-site audits, training, clinical reimbursement review, and team support.
This role is ideal for a highly organized MDS professional with strong knowledge of PDPM, RAI guidelines, CMI, care planning, Medicare documentation, and long-term care reimbursement systems.
Key Responsibilities
Provide regional oversight for MDS, PDPM, CMI, and RAI processes
Monitor timely and accurate MDS completion across assigned facilities
Review PDPM classifications, clinical documentation, diagnosis coding, and reimbursement accuracy
Support Case Mix Index improvement through accurate assessment and documentation
Audit MDS assessments for accuracy, compliance, and missed reimbursement opportunities
Review Medicare Part A documentation and skilled coverage support
Assist with Triple Check and Medicare meetings
Support facility MDS Coordinators, DONs, Administrators, and interdisciplinary teams
Review care plans for accuracy and alignment with MDS assessments
Monitor ARD schedules, assessment calendars, significant change assessments, and discharge assessments
Provide education and coaching to facility MDS and clinical teams
Assist with RAI Manual interpretation and regulatory compliance
Identify trends, risks, late assessments, coding errors, and reimbursement concerns
Participate in monthly or quarterly reimbursement reviews with regional leadership
Travel quarterly to assigned facilities for audits, training, and operational support
Qualifications
Active RN license required
Long-term care/skilled nursing experience required
MDS experience required
Strong knowledge of PDPM, RAI, CMI, Medicare, and Medicaid case mix processes
Experience with multi-facility MDS oversight preferred
RAC-CT certification preferred
Experience with Triple Check, Medicare meetings, care planning, and reimbursement audits preferred
Strong understanding of RAI Manual requirements
Ability to work independently from home
Strong communication, organization, auditing, and follow-through skills
Ability to travel quarterly to assigned facilities
Experience with PCC or similar electronic health record system preferred
Compensation & Benefits
Competitive salary or hourly rate
Primarily remote/work-from-home position
Quarterly travel reimbursement
Mileage reimbursement
Lodging and meal reimbursement when overnight travel is required
Licensure or certification reimbursement as approved
Opportunity to support multiple facilities and directly impact reimbursement accuracy, compliance, and clinical outcomes
