Fully Remote Nurse Consultant
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.
- 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.
- 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.
- Fully remote opportunity
- Standard Monday-Friday schedule
- Competitive hourly pay
- Opportunity to support meaningful healthcare review and quality initiatives
- Collaborative and professional team environment