Audit/Review Nurse (REMOTE- Pennsylvania ONLY)

Camp Hill, PA | Fully Remote

Posted: 11/21/2023 Category: Nursing Job Number: KS500947

Job Description


  • Responsible for reviewing and evaluating the medical necessity, appropriateness, quality, quantity, adequacy and compensability of medical care and services rendered by Home and Community Based Service providers under the Medical Assistance and Managed Care Organization (MCO) programs.


  • Work schedule: Mon-Fri, 8a-4:30p
  • Must be a resident of Pennsylvania to be considered
  • 100% REMOTE but will require training onsite for 2-4 weeks in Harrisburg, PA
  • This role is perfect for any RN seeking to leave bedside nursing/acute/clinical nursing and looking to gain experience working from home.
  • Full benefits available after 90 days: Medical, Dental, Vision, Life, Short-term Disability
  • 401k after 1 year of employment: With employer match and profit sharing
  • The compensation for this position is $30 per hour, paid weekly


  • Active RN License in the State of PA with NO past or present actions/suspensions or probation
  • Case Management, quality improvement, utilization review, HEDIS, claims investigation, appeals, coding experience preferred
  • New graduate RNs welcome to apply!
  • Computer savvy- experience with MS Office programs required.
  • High speed internet and private/quiet space to work remote is required.

PLEASE CALL OR TEXT: Alliston Brown @ 586-710-7944


RN, registered nurse, home care, home health, nurse, nursing, case manager, case management acute care, med surg, medical surgical, clinical, hospital, healthcare, discharge planning, assessment, care plans, managed care, insurance, health plan, remote, work from home, health insurance, patient care, urgent care, certified case manager, disease management, utilization review



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