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Fully Remote Nurse Consultant
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Fully Remote Nurse Consultant
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Job Title:
Nurse Consultant (Remote)
Location:
Remote (U.S.)
Pay Rate:
$30.00/hour
Schedule:
Monday-Friday | 8:30 AM - 5:00 PM
Position Overview
We are seeking an experienced
Nurse Consultant
to join a healthcare review team supporting clinical case evaluations and regulatory review processes. This fully remote role is ideal for a detail-oriented nursing professional with experience analyzing medical documentation, interpreting healthcare regulations, and making evidence-based clinical determinations.
Key Responsibilities
Review and evaluate clinical cases to ensure compliance with applicable healthcare regulations and guidelines.
Analyze medical records and supporting documentation to determine medical necessity.
Prepare clear, concise case summaries and clinical findings.
Resolve technical and clinical questions related to assigned case reviews.
Conduct medical and regulatory research to support case determinations and special projects.
Collaborate with cross-functional teams to ensure timely and accurate case processing.
Assist with process improvement initiatives and other projects as assigned.
Maintain confidentiality and adhere to quality, compliance, and productivity standards.
Required Qualifications
Bachelor's degree in Nursing or a related healthcare field.
3-5 years of clinical nursing, utilization review, case management, or healthcare consulting experience.
Strong clinical assessment and analytical skills.
Experience reviewing medical records and interpreting clinical documentation.
Excellent written and verbal communication skills.
Strong organizational skills with the ability to manage multiple priorities in a deadline-driven environment.
Proficiency with Microsoft Office and electronic medical record systems.
Preferred Qualifications
Experience supporting Medicare, health plan, payer, or regulatory review processes.
Prior experience in utilization management, medical necessity review, appeals, or case review.
Knowledge of healthcare compliance and regulatory guidelines.
Why Apply?
Fully remote opportunity
Standard Monday-Friday schedule
Competitive hourly pay
Opportunity to support meaningful healthcare review and quality initiatives