Job Description:
Overview:
Join a dynamic healthcare team as a Review Analyst I (Registered Nurse) in a remote, contract-based role. This opportunity is ideal for RNs looking to apply their clinical expertise in a non-bedside setting—reviewing medical documentation and supporting compliance, quality assurance, and utilization management from home.
About the Role:
As a Review Analyst I, you’ll work closely with clinical and administrative teams to evaluate healthcare claims, clinical records, and treatment authorizations. This position allows licensed nurses to transition into a data-driven, administrative role with the flexibility of remote work.
Key Responsibilities:
Conduct detailed clinical reviews of medical records and healthcare data
Evaluate the appropriateness of medical procedures using established criteria
Ensure documentation compliance with federal, state, and organizational guidelines
Collaborate with other clinical analysts and providers to resolve discrepancies
Prepare detailed reports and summaries of findings
Support audits and quality improvement initiatives as needed
Maintain confidentiality and data integrity in all case documentation
Requirements:
Active, unrestricted RN license in the U.S. (compact license preferred)
At least 2 years of clinical nursing experience (review or audit experience is a plus)
Familiarity with CMS, NCQA, or URAC guidelines a bonus
Detail-oriented with strong analytical and organizational skills
Proficient in EMR systems and Microsoft Office Suite
Reliable internet and a secure home office setup
What We Offer:
Competitive contract compensation ($40–$48 per hour)
100% remote flexibility
Supportive and collaborative virtual team
Professional development opportunities in health data review
Potential for contract renewal or permanent placement
How to Apply:
Submit your resume and a brief statement of interest highlighting your clinical and/or audit experience. We’re excited to review your application and welcome you into a fast-growing team that’s transforming healthcare from behind the scenes.