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Remote Rn Jcaho Jobs (NOW HIRING)

Remote RN Case Manager (Nationwide | Monday-Friday, No Weekends) Join a mission-driven team helping members achieve better health outcomes-100% remote. We're seeking an experienced Registered Nurse ...

Mercy Hospice RN Intake Nurse - St Louis Remote RN Opportunity - Non-Patient Contact Role | Must Reside Within 1 hour of a Mercy Hospital Evening/Night Shift - Mon-Thur - 40 hours a week - Shift: 4 ...

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Job Title: RN Case Manager Location: 100% Remote Duration: 12+ months License Required: Active & unrestricted Michigan RN license The RN Case Manager serves as the primary point of contact for ...

Mercy Hospice RN Intake Nurse - St Louis 🌐 Remote RN Opportunity - Non-Patient Contact Role | Must Reside Within 1 hour of a Mercy Hospital Evening/Night Shift - Mon-Thur - 40 hours a week - Shift ...

AIMS- REMOTE RN CARE MANAGER

NY · On-site +1

$61 - $63/hr

Current NYS RN license * Experience in case management, care coordination, or similar clinical ... Experience with telephonic care management or remote patient monitoring. * Familiarity with EHR ...

Must have active RN licensure in current state of practice. * 2-3 years of nursing experience with ... Remote work eligibility is subject to all work from home criteria met and based on business need.

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As of Jul 10, 2026, the average hourly pay for remote rn jcaho in the United States is $42.75, according to ZipRecruiter salary data. Most workers in this role earn between $29.09 and $54.33 per hour, depending on experience, location, and employer.
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Infographic showing various Remote Rn Jcaho job openings in the United States as of July 2026, with employment types broken down into 15% Internship, 4% As Needed, 65% Full Time, 15% Part Time, and 1% Contract. Highlights an 99% Physical, and 1% Remote job distribution, with an average salary of $88,916 per year, or $42.7 per hour.
Remote RN - Medical Claims Reviewer

Remote RN - Medical Claims Reviewer

Broadway Ventures

Nashville, TN • Remote

Full-time

Re-posted 28 days ago


Job description

At Broadway Ventures, we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), we empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth. Built on integrity, collaboration, and excellence, we're more than a service provider—we're your trusted partner in innovation.

Job Type: Full-time (40 hours/week)
Schedule: Monday–Friday, 8:00 AM – 5:00 PM

Max Salary: W-2 ($65,000/$31.25)

Location: Remote (U.S. – Work from home)
Remote Work Requirements: High-speed internet (non-satellite) and a private, lockable home office
Equipment: You will be provided with all necessary equipment to perform your job effectively, including but not limited to a desktop computer, dual monitors, a headset, an ethernet cable, and additional accessories as needed.

About the Role

We are seeking a dedicated Registered Nurse (RN) to join our Medical Review team. This role involves conducting pre- and post-payment medical reviews to ensure compliance with established clinical criteria and guidelines. The ideal candidate will use their clinical expertise to assess medical necessity, appropriateness, and reimbursement eligibility while documenting decisions in accordance with regulatory and organizational requirements.

Key Responsibilities
  • Review medically complex claims, pre-authorization requests, appeals, and fraud/abuse referrals.
  • Assess payment determinations using clinical information and established guidelines.
  • Evaluate medical necessity, appropriateness, and reasonableness for coverage and reimbursement.
  • Provide clear, well-documented rationales for service approvals or denials.
  • Educate internal and external teams on medical review processes, coverage determinations, and coding requirements.
  • Support quality control activities to meet corporate and team objectives.
  • Provide guidance to LPN team members and support non-clinical staff through training and discussions.
  • Assist with special projects and additional responsibilities as assigned.
Minimum QualificationsLicensure:
  • Active, unrestricted RN license in the U.S. and in the state of hire
    OR
  • Active compact multistate RN license (as defined by the Nurse Licensure Compact).
Education:
  • Associate Degree in Nursing
    OR
  • Graduate of an accredited School of Nursing.
Experience:
  • Two years of clinical experience plus at least two years in one of the following:
    • Home Health
    • Utilization/Medical Review
    • Quality Assurance
Skills & Competencies:
  • Strong clinical background in managed care, home health, rehabilitation, and/or medical-surgical settings.
  • Ability to interpret and apply medical review criteria and clinical guidelines.
  • Proficiency in Microsoft Office and word processing software.
  • Strong analytical, organizational, and decision-making skills.
  • Ability to work independently while managing priorities effectively.
  • Excellent customer service, communication, and critical thinking skills.
  • Ability to handle confidential information with discretion.
Preferred Qualifications
  • Three years of clinical nursing experience in Home Health, Utilization Review, Medical Review, or Quality Assurance (strongly preferred).
  • Proficiency in using multiple screens and software programs simultaneously.

If you are a detail-oriented RN with a passion for medical review, we encourage you to apply!

What to Expect Next:

After submitting your application, our recruiting team will review your qualifications. This may include a brief telephone interview or email communication to verify resume details and discuss compensation expectations. Interviews will be conducted with the most qualified candidates. Broadway Ventures conducts background checks and drug testing prior to the start of employment. Some positions may also require fingerprinting.

Broadway Ventures is an equal opportunity employer and a VEVRAA federal contractor. We do not discriminate against applicants or employees on the basis of race, color, religion, sex, national origin, age, disability, protected veteran status, or any other status protected by applicable law.

Reasonable accommodations are available for applicants with disabilities. Broadway Ventures utilizes the OFCCP-approved Voluntary Self-Identification of Disability Form (CC-305).