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Independent Review Nurse – Part Time
iMPROve Health. Perform independent clinical reviews supporting medical management, utilization review, external review, quality review, and other healthcare review programs .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in clinical reviews, medical record evaluation, and compliance with regulatory requirements such as HIPAA and CMS. Proficient in documenting findings and managing multiple cases while ensuring accuracy and adherence to deadlines.
Highest-signal resume keywords
Registered Nurse (RN) LicenseClinical Assessment SkillsMedical Record Review ExperienceUtilization Management ExperienceElectronic Case Management Systems Proficiency
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Clinical ReviewMedical Record EvaluationUtilization ReviewCase ManagementEvidence-Based Clinical GuidelinesRegulatory ComplianceCritical ThinkingDocumentation in APA FormatAttention to DetailOrganizational Skills
Soft Skills
Verbal CommunicationWritten CommunicationCustomer ServiceIndependenceFlexibility
Tools & Technologies
Microsoft OfficeElectronic Medical Record SystemsWeb-Based Healthcare PortalsProject Management ToolsRemote Collaboration Tools
Certifications & Qualifications
Bachelor's Degree in NursingRegistered Nurse (RN) License
Industry Keywords
HIPAACMSURACFISMAQuality AssuranceHealthcare Review ProgramsClinical DocumentationHealthcare ComplianceUtilization ReviewExternal Review
About the role
Key responsibilities & impact- Perform independent clinical reviews supporting medical management, utilization review, external review, quality review, and other healthcare review programs
- Review medical records and supporting documentation to make objective, clinically sound determinations
- Complete assigned case reviews accurately and within required turnaround times
- Prioritize incoming review assignments and manage multiple cases simultaneously
- Document review findings accurately in electronic case management systems and web-based portals
- Prepare clear, concise, and well-supported written determinations
- Ensure outgoing review documentation is complete, accurate, and submitted within contractual deadlines
- Maintain compliance with HIPAA, CMS, URAC, FISMA, and other applicable regulatory requirements
- Participate in quality assurance activities, audits, and ongoing training
- Collaborate effectively with internal teams while maintaining reviewer independence and objectivity
- Assist with additional review activities and projects as business needs require
- Work 20 hours per week during normal business hours, Monday through Friday, Eastern Time, with additional hours as needed
Requirements
What you’ll need- Bachelor's degree in nursing
- Current, unrestricted Registered Nurse (RN) license in any U.S. state (or as required by contract)
- Minimum of three (3) years of clinical nursing or related healthcare experience
- Experience reviewing medical records and clinical documentation
- Strong clinical assessment and critical thinking skills
- Excellent verbal communication skills
- Excellent written communication skills, including experience documenting in APA format
- Exceptional attention to detail and organizational skills
- Ability to manage multiple priorities while consistently meeting deadlines
- Strong customer service and professional communication skills
- Ability to work independently in a remote environment
- Ability to consistently meet assigned schedules and contractual turnaround times
- Flexibility to work additional hours, evenings, weekends, or holidays as required
- Reliable high-speed internet access
- Secure professional home office workspace supporting confidentiality and productivity
- Experience in utilization management, utilization review, case management, external review, or medical necessity review preferred
- Experience applying evidence-based clinical guidelines and regulatory requirements preferred
- Experience with electronic case management systems and healthcare portals preferred
- Proficiency with Microsoft Office, electronic medical record and case management systems, web-based healthcare portals, project management tools such as Asana, and standard remote collaboration tools
Benefits
Comp & perks- 100% remote work from anywhere in the United States
- Work/life balance
- Professional development and continuing education opportunities
- Medical insurance
- Dental insurance
- Vision insurance
- Life insurance
- Short-term disability
- Long-term disability
- Generous 401(k) match
- Flexible part-time schedule
- Collaborative team environment