Medical Review Nurse #37823
Clinical Research King of Prussia, PA
Contract Apr 3, 2025
Clinical Research
Job Title: Medical Review Nurse
Job Overview:
We are seeking a dedicated and detail-oriented Medical Review Nurse to join our client and play a vital role in supporting their healthcare operations. This 100% remote, temporary 6-month contract position focuses on conducting pre-authorization, utilization management, and case management reviews to ensure quality care and cost-effective treatment for members.
Compensation:
Work Schedule:
Key Responsibilities of the Medical Review Nurse:
Qualifications and Skills for the Medical Review Nurse:
Why Join Us?
This is an exciting opportunity to support global healthcare operations while working remotely in a collaborative and mission-driven environment. You’ll be part of a team that ensures patients receive medically necessary, appropriate, and high-quality care.
About Us:
Contemporary Staffing Solutions (CSS) is a trusted leader in providing contract, temporary, temp-to-hire, and direct hire staffing solutions. With decades of experience, we’ve grown from a staffing agency to a nationwide provider of workforce management solutions. Our niche recruitment expertise spans Accounting & Finance, Call Center & Office Support, Human Resources, Sales & Marketing, and Information Technology.
Explore more about CSS and how we connect great talent with exceptional opportunities by visiting www.ContemporaryStaffing.com.
Job Overview:
We are seeking a dedicated and detail-oriented Medical Review Nurse to join our client and play a vital role in supporting their healthcare operations. This 100% remote, temporary 6-month contract position focuses on conducting pre-authorization, utilization management, and case management reviews to ensure quality care and cost-effective treatment for members.
Compensation:
- $50/hour
Work Schedule:
- Tuesday through Saturday, 10:00 PM – 6:00 AM EST
- Training Schedule: Monday through Friday, daytime hours (flexible depending on time zone)
Key Responsibilities of the Medical Review Nurse:
- Conduct prospective, concurrent, and retrospective reviews for inpatient, rehabilitation, and select outpatient services.
- Evaluate medical necessity of services using international standards and proprietary guidelines.
- Refer cases to the Medical Director in accordance with protocol.
- Document case activities and maintain data in the clinical management system.
- Educate members on country-specific healthcare systems and provider capabilities.
- Research health promotion and chronic condition management topics as needed.
- Participate in discharge planning and coordinate appropriate resources for care transitions.
- Collaborate and communicate with internal and external stakeholders to ensure timely case progression.
- Facilitate emergency medical transport in coordination with international on-site staff.
- Support new hire training and cross-departmental knowledge sharing.
- Participate in committee and project work as assigned.
- In case management-specific duties, assess needs, coordinate care plans, and promote wellness and autonomy.
Qualifications and Skills for the Medical Review Nurse:
- Active, unrestricted RN license (PA or Compact state license preferred).
- Minimum three years of clinical nursing experience.
- Ability to independently research international medical care standards.
- Familiarity with U.S. managed care systems and experience in international care preferred.
- Strong interpersonal, negotiation, time management, and organizational skills.
- Proficient computer and documentation skills.
- Availability for on-call weekends, holidays, and rotating night shifts.
- Multilingual capability is a plus.
- CCM certification preferred, but not required.
- Reliable internet connection (minimum 75 Mbps).
Why Join Us?
This is an exciting opportunity to support global healthcare operations while working remotely in a collaborative and mission-driven environment. You’ll be part of a team that ensures patients receive medically necessary, appropriate, and high-quality care.
About Us:
Contemporary Staffing Solutions (CSS) is a trusted leader in providing contract, temporary, temp-to-hire, and direct hire staffing solutions. With decades of experience, we’ve grown from a staffing agency to a nationwide provider of workforce management solutions. Our niche recruitment expertise spans Accounting & Finance, Call Center & Office Support, Human Resources, Sales & Marketing, and Information Technology.
Explore more about CSS and how we connect great talent with exceptional opportunities by visiting www.ContemporaryStaffing.com.