Top 14 Rn work from home Jobs in Johnston, Ia

Medical Review Nurse (AIMRR) 2
EPATHUSA INC —Clive, IA
- $76,875 - $97,375 a year
- Full-time
- Remote
- Nursing
- RN License
- Bachelor of Science in Nursing
8d
Maternity RN Care Manager
Iowa Total Care —Des Moines, IA
- $56,200 - $101,000 a year
- Full-time
- Remote
- Nursing
- RN License
- Mid-level
- Paid holidays
- Health insurance
21h
Registered Nurse - RN - Local Traveler
Good Samaritan —Carlisle, IA
- $32 - $48 an hour
- Online Application
- Remote
- Background check
- 18 years or older
- Nursing
Quick Apply
Aesthetics Professional Injector
GlamNow —United States
- $150 - $500 an hour
- Choose your own hours
- Remote
- Background check
- RN License
- Sales
- Employee discount
- Opportunities for advancement
Quick Apply
Remote Registered Nurse (RN), Bilingual | $35.50/hr
Carenet Health —United States
- $35.50 an hour
- Weekends as needed
- Remote
- Spanish
- Nursing
- RN License
- Paid holidays
- Health insurance
8d

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Maternity RN Care Manager
Iowa Total Care —Des Moines, IA
Preference will be given to applicants who (1) reside in Iowa, (2) have an Active Iowa RN license as well as (3) experience with case management and prenatal /…
$56,200 - $101,000 a year
21h
RN Case Manager
Cottingham & Butler —Des Moines, IA
The RN Case Manager will assess, plan, implement, coordinate, monitor, and evaluate care for assigned consumers, ensuring quality outcomes and cost-effective…
Quick Apply

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Care Manager (RN)
Axelon Services Corporation —Ohio
Provide high-quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families.
$48.35 an hour
Quick Apply
Case Manager-RN or LSW-Ohio Licensed-Remote w/Field Visits
The Maxis Group —Ohio
Mostly telephonic/work from home with 0-3 field visits a week on average.*. Required Education/Certification(s):* RN/LSW/LISW - must be licensed in OHIO.
Up to $44 an hour
Quick Apply
10d

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rn work from home jobs near johnston, ia

Medical Review Nurse (AIMRR) 2

EPATHUSA INC -
Clive, IA

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Job Details

Full-time
$76,875 - $97,375 a year
8 days ago

Qualifications

Utilization review
RN License

Full Job Description

Seeking Registered Nurse for fully remote role to perform complex medical record and claim reviews (Standard or Program Integrity) to make coverage determinations based on applicable Medicare coverage policies and payment rules, coding guidelines, National and Local Coverage Determinations, utilization/practice guidelines, clinical review judgment and when appropriate, monitor for potential indicators of fraud, waste, and abuse. Provides professional assessment, planning, coordination, implementation, and reporting of complex data to support the Medical Review Accuracy Contract (MRAC).

Essential Functions

Perform complex medical record and claims review in accordance with all State and Federal mandated regulations/guidelines.
Accurately enter medical review data into the medical review system.
Apply clinical review judgment, based on clinical experience when applicable and review completeness of documentation to determine if documentation supports claim as billed.
Reasonably determines appropriateness to consult a Subject Matter Expert (SME) for clarification.
When performing Program Integrity (PI) reviews, assess investigative allegations and medical review findings, and/or other claims data to determine patterns and detect potential indicators of fraud, waste and abuse (FWA).
Accurately identify additional findings in the review of evidence of potential FWA not detected by the Medical Review Contractor.
Consistently meet or exceed productivity and accuracy standards of 98% minimum IRR established by the customer and/or the Company.

Registered Nurse, with a current unobstructed license to practice nursing in the United States. Graduate of a Board approved Registered Nursing program.
A Bachelor’s Degree in Nursing (BSN) or other related field is preferred.
Certification in coding highly preferred.
A minimum of five (5) years clinical experience in an acute care hospital, skilled nursing facility, and/or an office/clinic-based medical practice.
A minimum of three (3) or more years’ experience in medical/utilization medical record review particularly with Medicare and/or Medicaid.
Minimum of 2 (two) years’ experience in the medical review processes of MACs, SMRC, CERT, QICs and/or BFCC-QIOs.
Desired experience performing medical review for fraud, waste, and abuse (FWA) investigations.
Knowledgeable of ICD-9-CM, ICD-10, CPT-4 and HCPCS coding.
One year or more of utilizing InterQual and/or Milliman guidelines against inpatient services experience is preferred.

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rn work from home jobs in johnston, ia

Medical Review Nurse (AIMRR) 2

Maternity RN Care Manager

Registered Nurse - RN - Local Traveler

Aesthetics Professional Injector

Remote Registered Nurse (RN), Bilingual | $35.50/hr

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