Job Summary Provides support for clinical member services review assessment processes. Responsible ... Registered Nurse (RN). License must be active and unrestricted in state of practice. SC Single ...
Job Summary Provides support for clinical member services review assessment processes. Responsible ... Registered Nurse (RN). License must be active and unrestricted in state of practice. SC Single ...
(RN) Remote Care Review Clinician - Utilization Review
Long Beach, CA · On-site +1
$25.08 - $51.49/hr
Job Summary Provides support for clinical member services review assessment processes. Responsible ... SC Single state or Compact RN License. • Ability to prioritize and manage multiple deadlines. • ...
(RN) Remote Care Review Clinician - Utilization Review
Long Beach, CA · On-site +1
$25.08 - $51.49/hr
Job Summary Provides support for clinical member services review assessment processes. Responsible ... SC Single state or Compact RN License. • Ability to prioritize and manage multiple deadlines. • ...
(RN) Remote Care Review Clinician - Utilization Review
Long Beach, CA · Remote
$25.08 - $51.49/hr
Job Summary Provides support for clinical member services review assessment processes. Responsible ... Registered Nurse (RN). License must be active and unrestricted in state of practice. SC Single ...
New
(RN) Remote Care Review Clinician - Utilization Review
Long Beach, CA · Remote
$25.08 - $51.49/hr
Job Summary Provides support for clinical member services review assessment processes. Responsible ... Registered Nurse (RN). License must be active and unrestricted in state of practice. SC Single ...
New
Care Review Clinician (RN) Remote
Long Beach, CA · On-site +1
$26.41 - $51.49/hr
This RN will act as a Care Review Clinician supporting our Medicaid members who have recently been ... This is a telephonic remote position and productivity is important. Preferred candidates will have ...
Care Review Clinician (RN) Remote
Long Beach, CA · On-site +1
$26.41 - $51.49/hr
This RN will act as a Care Review Clinician supporting our Medicaid members who have recently been ... This is a telephonic remote position and productivity is important. Preferred candidates will have ...
Lead, Medical Review Nurse (RN) Remote
Long Beach, CA · Remote
$37 - $50.25/hr
Integrates medical chart coding principles, clinical guidelines, and objectivity in performance of ... Demonstrates ownership of medical claim/internal appeals review job aids to ensure accuracy.
Lead, Medical Review Nurse (RN) Remote
Long Beach, CA · Remote
$37 - $50.25/hr
Integrates medical chart coding principles, clinical guidelines, and objectivity in performance of ... Demonstrates ownership of medical claim/internal appeals review job aids to ensure accuracy.
Care Review Clinician (RN) Remote
Long Beach, CA · On-site +1
$23.76 - $51.49/hr
This RN will act as a Care Review Clinician supporting our Medicare members who have recently been ... This is a remote position and productivity is important. Preferred candidates will have previous ...
Care Review Clinician (RN) Remote
Long Beach, CA · On-site +1
$23.76 - $51.49/hr
This RN will act as a Care Review Clinician supporting our Medicare members who have recently been ... This is a remote position and productivity is important. Preferred candidates will have previous ...
Job Summary Provides support for clinical member services review assessment processes. Responsible ... Registered Nurse (RN). License must be active and unrestricted in state of practice(Nevada)
Job Summary Provides support for clinical member services review assessment processes. Responsible ... Registered Nurse (RN). License must be active and unrestricted in state of practice(Nevada)
Remote Care Review Clinician- Utilization Review- NV RN license req.
Long Beach, CA · On-site +1
$23.76 - $51.49/hr
Job Summary Provides support for clinical member services review assessment processes. Responsible ... (RN). License must be active and unrestricted in state of practice(Nevada). • Ability to ...
Remote Care Review Clinician- Utilization Review- NV RN license req.
Long Beach, CA · On-site +1
$23.76 - $51.49/hr
Job Summary Provides support for clinical member services review assessment processes. Responsible ... (RN). License must be active and unrestricted in state of practice(Nevada). • Ability to ...
... inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience. Registered Nurse (RN). License must be active and unrestricted in state of ...
... inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience. Registered Nurse (RN). License must be active and unrestricted in state of ...
Utilization Review Supervisor RN
Rancho Cucamonga, CA · Remote
$77K - $120K/yr
The Utilization Review Supervisor RN is responsible for directing the operations of their ... This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Responsible for directing a ...
Quick apply
Utilization Review Supervisor RN
Rancho Cucamonga, CA · Remote
$77K - $120K/yr
The Utilization Review Supervisor RN is responsible for directing the operations of their ... This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Responsible for directing a ...
Utilization Review Supervisor RN
Rancho Cucamonga, CA · Remote
$77K - $120K/yr
The Utilization Review Supervisor RN is responsible for directing the operations of their ... This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Responsible for directing a ...
Utilization Review Supervisor RN
Rancho Cucamonga, CA · Remote
$77K - $120K/yr
The Utilization Review Supervisor RN is responsible for directing the operations of their ... This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Responsible for directing a ...
Remote, but only considering candidates in PST. FLSA Status: Exempt Travel Requirement: None ... Conduct live reviews with payors and level of care chart reviews, conceptualizing the clinical ...
Quick apply
Remote, but only considering candidates in PST. FLSA Status: Exempt Travel Requirement: None ... Conduct live reviews with payors and level of care chart reviews, conceptualizing the clinical ...
CA Utilization Review Nurse I
Rancho Cucamonga, CA · Remote
$30.64 - $45.80/hr
This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Identifies the necessity of ... Current Nursing licensure in the state of operation required; RN is required unless local state ...
CA Utilization Review Nurse I
Rancho Cucamonga, CA · Remote
$30.64 - $45.80/hr
This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Identifies the necessity of ... Current Nursing licensure in the state of operation required; RN is required unless local state ...
CA Utilization Review Nurse I
Rancho Cucamonga, CA · Remote
$30.64 - $45.80/hr
This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Identifies the necessity of ... Current Nursing licensure in the state of operation required; RN is required unless local state ...
Quick apply
CA Utilization Review Nurse I
Rancho Cucamonga, CA · Remote
$30.64 - $45.80/hr
This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Identifies the necessity of ... Current Nursing licensure in the state of operation required; RN is required unless local state ...
... inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience. Registered Nurse (RN). License must be active and unrestricted in state of ...
... inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience. Registered Nurse (RN). License must be active and unrestricted in state of ...
Care Review Clinician (RN) - Remote in FL
Long Beach, CA · On-site +1
$26.41 - $51.49/hr
... review, prior authorization, managed care, or equivalent combination of relevant education and experience. • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ...
Care Review Clinician (RN) - Remote in FL
Long Beach, CA · On-site +1
$26.41 - $51.49/hr
... review, prior authorization, managed care, or equivalent combination of relevant education and experience. • Registered Nurse (RN). License must be active and unrestricted in state of practice. • ...
Care Review Clinician (RN) - Remote in FL
Long Beach, CA · Remote
$26.41 - $43/hr
... inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience. Registered Nurse (RN). License must be active and unrestricted in state of ...
Care Review Clinician (RN) - Remote in FL
Long Beach, CA · Remote
$26.41 - $43/hr
... inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience. Registered Nurse (RN). License must be active and unrestricted in state of ...
... (RNs), Health Guides, Behavioral Health Specialists, and other clinical partners to deliver ... Nurse Practitioners through collaborative practice agreements, including structured chart review ...
Quick apply
... (RNs), Health Guides, Behavioral Health Specialists, and other clinical partners to deliver ... Nurse Practitioners through collaborative practice agreements, including structured chart review ...
**Fully remote opportunity requiring an active Illinois nursing license. The role operates Monday ... Candidates should be comfortable performing utilization reviews and making clinical determinations ...
New
**Fully remote opportunity requiring an active Illinois nursing license. The role operates Monday ... Candidates should be comfortable performing utilization reviews and making clinical determinations ...
New
**Fully remote opportunity requiring an active Illinois nursing license. The role operates Monday ... Candidates should be comfortable performing utilization reviews and making clinical determinations ...
New
**Fully remote opportunity requiring an active Illinois nursing license. The role operates Monday ... Candidates should be comfortable performing utilization reviews and making clinical determinations ...
New
Remote Rn Chart Review information
See Anaheim, CA salary details
$16.56 - $20.95
3% of jobs
$20.95 - $25.33
4% of jobs
$29.35 is the 25th percentile. Wages below this are outliers.
$25.33 - $29.72
19% of jobs
The median wage is $32.47 / hr.
$29.72 - $34.10
37% of jobs
$37.94 is the 75th percentile. Wages above this are outliers.
$34.10 - $38.49
13% of jobs
$38.49 - $42.87
9% of jobs
$42.87 - $47.26
4% of jobs
$47.26 - $51.64
3% of jobs
$51.64 - $56.03
3% of jobs
$56.03 - $60.41
1% of jobs
$60.41 - $64.80
3% of jobs
$16
$37
$64
How much do remote rn chart review jobs pay per hour?
What are the key skills and qualifications needed to thrive as a Remote RN Chart Review, and why are they important?
How Can I Get a Remote Job as a Chart Review RN?
The qualifications to get a remote job as a chart review nurse include a nursing degree, a nursing license, and experience using medical records and coding systems. You can start out on this career path by becoming a registered nurse (RN) or a practical nurse (LPN). This process involves earning an associate or bachelor’s degree in nursing and passing the NCLEX-RN licensing exam. It’s essential to have strong communication and analytical skills, attention to detail, and a reliable computer with internet access to work from home. Earning certification from the American Association of Medical Audit Specialists or the American Academy of Professional Coders is a plus.
What is a Remote RN Chart Review?
What is the difference between Remote Rn Chart Review vs Remote LPN Chart Review?
| Aspect | Remote Rn Chart Review | Remote LPN Chart Review |
|---|---|---|
| Credentials | Registered Nurse (RN) license | Licensed Practical Nurse (LPN) license |
| Work Environment | Healthcare facilities, insurance companies, telehealth | Similar settings, often with more limited scope |
| Job Responsibilities | Comprehensive chart review, complex case analysis | Basic chart review, documentation verification |
Remote Rn Chart Review and Remote LPN Chart Review both involve reviewing patient records remotely. However, RNs typically handle more complex cases requiring a broader scope of practice and higher credentials, while LPNs focus on more routine documentation tasks. Both roles are essential in healthcare documentation and insurance claims, but RNs generally have more advanced responsibilities and qualifications.
What are some common challenges faced by Remote RN Chart Review nurses, and how can they be overcome?

Full-time
Posted 18 days ago
Molina Healthcare rating
8.1
Based on 193 frontline employees who took The Breakroom Quiz
134th of 281 rated insurance
Job description
JOB DESCRIPTION
Job Summary
Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
Assesses services for members to ensure optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines.
Analyzes clinical service requests from members or providers against evidence based clinical guidelines.
Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures.
Conducts reviews to determine prior authorization/financial responsibility for Molina and its members.
Processes requests within required timelines.
Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner.
Requests additional information from members or providers as needed.
Makes appropriate referrals to other clinical programs.
Collaborates with multidisciplinary teams to promote the Molina care model.
Adheres to utilization management (UM) policies and procedures.
Required Qualifications
At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience.
Registered Nurse (RN). License must be active and unrestricted in state of practice. SC Single state or Compact RN License.
Ability to prioritize and manage multiple deadlines.
Excellent organizational, problem-solving and critical-thinking skills.
Strong written and verbal communication skills.
Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
Certified Professional in Healthcare Management (CPHM).
Recent hospital experience in an intensive care unit (ICU) or emergency room.
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