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Remote Jobs with RN licensure Certification

32 fresh jobs found

Case Manager RN (Remote)
Work At Home-Arizona, United States

High-Speed Internet Telephonic assessment Telework Clinical Tools Data Review RN license Telephonic Communication Member engagement RN licensure +21

Senior Mid Full Time

USD 54K+

Case Manager RN
Work At Home-North Carolina, United States

Telephonic assessment Emergency department Integrative functions Telephonic case management Clinical resources Long Term Care Clinical Tools Holistic approach RN license +27

USD 54K+

Utilization Review Nurse
Remote

Care engagement Level of care reviews Milliman care guidelines Medical necessity reviews Evidence-Based Guidelines Clinical Guidelines Clinical Review RN licensure Technology Platform +13

USD 70K+

Case Manager
High Point-4050 Piedmont Parkway, United States

Emergency department Integrative functions Telephonic case management Clinical resources Long Term Care Clinical Tools Holistic approach RN license Data Review +27

USD 54K+

Care Manager RN
Work At Home-Colorado

High-Speed Internet Clinical Tools RN license Data Review Telephonic Communication Member engagement Policies and procedures RN licensure Acute care +18

USD 60K+

DRG Nurse Quality Auditor, Sr. Specialist - Remote in US
Any city, AR, US, 99999

Gainwell Technologies

Policy support DRG auditing Training Initiatives CC APR-DRG MCC MS-DRG DRG validation Medical record documentation +45

Senior Full Time

USD 64K+

Clinical Quality Nurse Reviewer, Sr. Specialist - (RN Remote in US)
Any city, ID, US, 99999

Gainwell Technologies

Inter-rater reliability Acute care experience Clinical quality review Production Environment MCG criteria Clinical criteria guidelines InterQual criteria Chart Audits Medical Record Review +36

Senior Full Time

USD 64K+

Case Manager RN - Maternity/Fertility
Work At Home-Ohio

Ob-gyn Maternity Infertility Women's Health Telephonic case management Integrative functions Clinical resources Clinical Tools Holistic approach +24

USD 54K+

Nurse Reviewer, Appeals and Hearings (Remote)
Any city, LA, US, 99999

Gainwell Technologies

Appeals process MCG criteria Medical record coding Clinical criteria guidelines InterQual criteria Coding certification CCS CPC InterQual +28

USD 64K+

Case Manager RN
Work At Home-Pennsylvania

Integrative functions Telephonic assessment Clinical resources Clinical Tools Holistic approach Data Review Policies and procedures Care Planning RN licensure +18

USD 60K+

Utilization Management Nurse Consultant - Remote
Work At Home-New York

Navigating multiple systems Benefit utilization Keyboarding Clinical Criteria RN licensure Clinical assessment Registered Nurse Computer Proficiency Utilization management +18

USD 52K+

Case Manager RN (Remote)
Work At Home - Utah

Integrative functions Clinical resources Clinical Tools Holistic approach Data Review Policies and procedures Care Planning RN licensure Member engagement +21

USD 54K+

Clinical Transformation Manager - Enterprise Monitoring as a Service (Travel: National)
United States of America - Remote Based

Clinical transformation Clinical optimization Clinical workflow Clinical services Workflow Optimization Environmental Clinical Experience Travel Office +19

Senior Full Time

USD 102K+

Case Manager RN
Work At Home-Arizona

Telephonic Communication RN license Clinical Tools Data Review Policies and procedures RN licensure Acute care Member engagement Discharge planning +20

USD 54K+

Utilization Manager Nurse Consultant
Work At Home-Texas

Med/surg Inpatient utilization Benefit utilization Coverage determination Benefit management Medical necessity Clinical Criteria RN licensure Discharge planning +22

USD 58K+

Case Manager RN
Work At Home-New York

Healthcare programs Data-driven methods Telephonic case management RN license RN licensure Health Literacy Member engagement Discharge planning Referrals +27

USD 66K+

Transition of Care Nurse - RN
Work At Home-Virginia

Clinical Assistance Goal Attainment Home health care coordination Home health care Emergency department Proprietary applications Navigating multiple systems RN license Keyboarding +34

USD 60K+

Case Manager RN
Work At Home-Missouri

Integrative functions Health Assessment Telework Telephonic Communication RN license Clinical Tools Clinical resources Holistic approach Data Review +22

USD 54K+

Utilization Management Nurse Consultant
Work At Home-Texas

Benefit utilization Coverage determination Benefit management Long Term Care Telephonic Communication Medical necessity Clinical Criteria RN licensure Home Health +32

USD 58K+

Utilization Management Nurse Consultant
Work At Home-North Carolina

Multi-systems navigation Benefit utilization Coverage determination Benefit management Navigating multiple systems Keyboarding Clinical Criteria Fast-paced Environment RN licensure +24

USD 52K+

Case Manager RN- Pennsylvania
Work At Home-Pennsylvania

Emergency department Long Term Care Clinical resources Clinical Tools Holistic approach Data Review Policies and procedures RN licensure Discharge planning +23

USD 60K+

UM Nurse Consultant - Prior Authorization
Work At Home-Ohio

Benefit utilization Coverage determination Benefit management Navigating multiple systems Medical necessity Clinical Criteria Keyboarding RN licensure Discharge planning +27

USD 52K+

Registered Nurse with Coding Certificate - Remote in US
Any city, OK, US, 99999

Gainwell Technologies

AP-DRG HMS Auditing Systems Clinical auditing CC Internet browsers MCC Coding reviews Clinical review judgment Regulatory support +57

Senior Mid Full Time

USD 59K+

Clinical Associate (Field based)
Michigan, Virtual Address

Post-deployment services Acute care products Customer Excellence Critical care Clinical Strategy Interdisciplinary Collaboration Clinical Training Acute care Customer requirements +11

USD 67K+

Case Manager RN- Maternity/Fertility
Work At Home-Arizona

Maternity Telephonic case management Ob-gyn Infertility Women's Health RN license Clinical resources Clinical Tools Holistic approach +23

USD 54K+

Transition of Care Nurse - RN
Work At Home-Connecticut

Home health care coordination Clinical Assistance Goal Attainment Emergency department Proprietary applications Navigating multiple systems Clinical resources Keyboarding Holistic approach +32

USD 66K+

Utilization Managment Nurse Consultant
Work At Home-California

Benefit management Benefit utilization Coverage determination Long Term Care Clinical Criteria Medical necessity Telephonic Communication RN licensure Utilization Review +29

Entry Mid Full Time

USD 64K+

DRG Nurse Quality Auditor, Sr. Specialist - Remote in US
Any city, OK, US, 99999

Gainwell Technologies

CC Education content development DRG auditing MCC Coding reviews Payment methodologies DRG validation Training Initiatives APR-DRG +38

Senior Full Time

USD 64K+

Clinical Quality Nurse Reviewer, Sr. Specialist - (RN Remote in US)
Any city, NC, US, 99999

Gainwell Technologies

Clinical quality review InterQual criteria Chart Audits Clinical criteria guidelines Productivity standards Medical Record Review RN license InterQual Clinical Criteria +28

Senior Full Time

USD 64K+

Clinical Associate (Field-Based)
Minnesota, Minneapolis Virtual Address

Acute care products Post-deployment services Customer Excellence Critical care Clinical Strategy Interdisciplinary Collaboration Acute care Clinical Training Customer requirements +10

USD 70K+

Appeals Review Nurse
Remote

NCCN Medical decision support tools Level of care reviews Medical necessity reviews Milliman care guidelines Evidence-Based Guidelines InterQual MCG Clinical Guidelines +16

Entry Mid Full Time

USD 70K+

Clinical Specialist, South (field-based)
Florida, Virtual Address

Clinical insights Tool optimization Performance evaluations Clinical Standards Critical care Metrics Tracking Acute care Medical Information Performance Evaluation +18

USD 85K+

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