Remote Nurse Reviewer

Ensemble Health Partners is seeking an experienced RN for Utilization Review to assess medical necessity and optimize hospital and patient care. This remote role involves coordinating with the FCC, care management, and interdisciplinary teams to ensure appropriate level of care across cases. The candidate should hold an active RN license with 3+ years of...

Integra Partners seeks an experienced LPN/LVN to conduct pre-service and post-service utilization reviews and appeals within a NCQA-compliant UM program, collaborating with our Medical Director. The role emphasizes applying federal/state mandates, plan benefits, and guidelines such as InterQual and CMS to determine medical necessity, with responsibilities...

All job postings will expire at 11:59 PM Eastern Time on the application deadline.  Organization: Health Agency Contact Name and Information: G. Anderson will contact you if selected for interview Work Location: 246 North High Street, 1st FloorColumbus, Ohio, 43215United States Compensation: $36.01 Schedule: Permanent - Full Time Work...

Conduent is seeking a Medical Benefits Review Associate Pay: Starting at $18.00/hour, fully remote. Monday-Friday | 8:00 AM -4:30 PM EST. The role involves analytical support for Medicare, Medicaid, and Commercial claim overpayments, using client claims systems and related software. You will review paid/adjusted/offset claims and document findings, requiring...

CVS Health Nurse RoleWe're building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part...

Remote | Flexible Hours | Contract | Data Labeling Pay Rate: $17/hr (USD) At Workada, we're not just labeling data, we're helping improve the technology people use every day. Our work creates the examples and feedback that make advanced systems more accurate, consistent, and useful. What You'll Do Evaluate outputs from AI models, text, images,...

Gainwell Technologies is seeking a Nurse Reviewer (RN) to perform clinical reviews determining medical necessity and documenting findings. You will access proprietary systems, apply criteria, and support review determinations with policy and regulatory knowledge. The role is full-time, with day-one benefits, and offers a remote option for US-based employees....

Remote | Flexible Hours | Contract | Data Labeling Pay Rate: $17/hr (USD) At Workada, we're not just labeling data, we're helping improve the technology people use every day. Our work creates the examples and feedback that make advanced systems more accurate, consistent, and useful. What You'll Do Evaluate outputs from AI models, text, images,...

Remote | Flexible Hours | Contract | Data Labeling Pay Rate: $17/hr (USD) At Workada, we're not just labeling data, we're helping improve the technology people use every day. Our work creates the examples and feedback that make advanced systems more accurate, consistent, and useful. What You'll Do Evaluate outputs from AI models, text, images,...