Title : Nurse RN 3 (Clinical Quality Review Nurse) - Remote
Remote | California Citizen
Contract : 9+ Months with Possible Extension
Schedule : Monday–Friday | 8 : 00 AM – 4 : 30 PM | 40 Hours / Week
Required Qualifications
- Active and unrestricted California RN License
- Associate's or Bachelor's Degree in Nursing
- Proven experience working remotely with strong computer and organizational skills
- 2+ years Experience with health plans, managed care organizations, IPA groups, or similar environments
Preferred Qualifications
2 + years Extensive clinical experience within a hospital or acute care setting2+ years Previous experience in quality review, utilization management (UM), case management (CM), or peer review supportFamiliarity with clinical investigation workflows, committee case preparation, and corrective action processes