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.
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