Remote RN Clinical Quality & Utilization Reviewer

Lynn Rodens; Phoenix (AZ); Remoto; USD 85.000 - 92.000; Tempo pieno

Descrizione del lavoro

Lynn Rodens is seeking a skilled Clinical Reviewer/Nurse for a remote role aligned with AZ hours. The position requires active RN license, U.S. citizenship, 3+ years in med/surg and/or behavioral health, and eligibility for DoD background clearance.

Ideal candidates have strong documentation and writing abilities, plus experience with health plans or large healthcare systems. This role focuses on quality review, PQIs, and collaborating with Medical Directors to drive improvement.

Competenze

• Active, unrestricted RN license required.
• Minimum 3+ years clinical experience (med/surg and/or behavioral health).
• Strong clinical documentation and writing ability.

Mansioni

• Review medical records for quality, safety, and utilization issues.
• Identify PQIs and document findings.
• Write detailed case summaries and recommendations.
• Support peer review and quality improvement initiatives.
• Collaborate with Medical Directors on improvements.
• Analyze trends and ensure regulatory program compliance.

Conoscenze

Clinical documentation

Writing ability

Analytical skills

Formazione

Bachelor’s degree in Nursing or healthcare-related field

Descrizione del lavoro

Lynn Rodens is seeking a skilled Clinical Reviewer/Nurse for a remote role aligned with AZ hours. The position requires active RN license, U.S. citizenship, 3+ years in med/surg and/or behavioral health, and eligibility for DoD background clearance.

Ideal candidates have strong documentation and writing abilities, plus experience with health plans or large healthcare systems. This role focuses on quality review, PQIs, and collaborating with Medical Directors to drive improvement.