Remote RN Reviewer - Utilization Review Expert

Gainwell Technologies LLC; Orange Beach (AL); Remote; USD 65,000 - 75,000; Full time

Benefits offered by this job

Health benefits (medical, dental, vision)

Company-provided computer

Paid time off benefits

Job summary

Gainwell Technologies LLC is seeking a Nurse Reviewer (RN) to perform clinical reviews remotely in the United States. Responsibilities include reviewing medical records, documenting findings, and supporting decision-making within healthcare guidelines. Candidates must have an active RN license, 5+ years of clinical experience, and 2+ years in utilization review or claims auditing. This full-time position offers health benefits starting on day one and a salary range of $65,000—$75,000 per year based on qualifications and experience.

Qualifications

• 5+ years of clinical experience in an inpatient hospital setting.
• 2+ years of utilization review experience or claims auditing.
• Active, unrestricted RN licensure from the United States.

Responsibilities

• Conduct clinical reviews to assess medical documentation.
• Document findings and provide policy support.
• Train and mentor new Nurse Reviewers.

Skills

Clinical experience in an inpatient hospital setting

Utilization review experience

Proficiency in Microsoft Office

Critical thinking

Education

Active, unrestricted RN licensure

Tools

Milliman

InterQual

Job description

Gainwell Technologies LLC is seeking a Nurse Reviewer (RN) to perform clinical reviews remotely in the United States. Responsibilities include reviewing medical records, documenting findings, and supporting decision-making within healthcare guidelines. Candidates must have an active RN license, 5+ years of clinical experience, and 2+ years in utilization review or claims auditing. This full-time position offers health benefits starting on day one and a salary range of $65,000—$75,000 per year based on qualifications and experience.