Immediate Hiring Need – Remote RN Opportunity
We are seeking experienced Registered Nurses with a strong background in Clinical Quality, Utilization Review, Case Management, or Chart Auditing for a fully remote Clinical Quality Reviewer opportunity.
This is an excellent opportunity for RNs with managed care, health plan, inpatient review, or quality improvement experience who enjoy analytical work, clinical documentation review, and improving patient care outcomes.
Review medical records for quality, compliance, and medical necessity
Conduct chart audits and documentation reviews
Identify potential quality issues and recommend improvements
Write detailed clinical summaries and recommendations
Apply InterQual and evidence-based criteria
Collaborate with Medical Directors, case managers, and interdisciplinary teams
Support quality improvement and peer review initiatives
Ensure compliance with regulatory and healthcare program standards
Active RN license
3+ years of clinical nursing experience
Strong utilization review, quality review, or case management background
Experience reviewing medical records and clinical documentation
InterQual experience strongly preferred
Inpatient Med-Surg or acute care experience preferred
Excellent analytical and written communication skills
Experience with managed care, health plans, or government healthcare programs is a plus
Clinical Quality RN
Utilization Review RN
Case Management RN
Managed Care RN
Clinical Documentation Review RN
Concurrent Review Nurse
Appeals & Grievances RN
Quality Improvement RN
HEDIS / NCQA
Medicare / Medicaid
Appeals & denials
Regulatory compliance
Care coordination
Audit readiness
Data analysis and reporting
If you are an experienced RN looking to transition into a high-impact remote clinical quality role, we encourage you to apply today.
Email your resume today!
mpalkin@teemagroup.com