Job Description

Job Description

Job Description

A-Line Staffing is hiring a Remote Clinical Review Nurse (LPN/RN) with a Major Healthcare Company!

Pay Rate: $35–$42/hr - Based on licensure and experience!
Schedule: Monday–Friday, 8:00 AM–5:00 PM PST (occasional weekend/holiday rotation - will be required to do 1 weekend per month!)
Location: Remote (must reside in CST)

Overview:

This role supports the Medicaid Plan team, reviewing prior authorization and inpatient requests.

Key Responsibilities:

• Review clinical charts for medical necessity for inpatient admissions
• Utilize InterQual to review medical necessities
• Review, evaluate, and process prior authorization (PA) and inpatient (IP) requests
• Make clinical determinations using established criteria and guidelines
• Document all review findings accurately and efficiently
• Collaborate with peers and leadership to ensure timely completion of authorizations
• Participate in occasional weekend or holiday rotations as needed

Required Experience & Qualifications:

• Licensure: Active LPN or RN license
• Experience: Requires at least two years of Acute Care or ICU care experience
• Strong attention to detail and clinical judgment
• Excellent written and verbal communication skills
• Ability to work both independently and collaboratively in a remote environment

Preferred Qualifications:

• Positive, team-oriented attitude and willingness to learn
• Strong time management and multitasking skills
• Prior experience with Medicaid or TruCare systems a plus

Performance Expectations:

• Complete up to 20 authorization reviews per day with high accuracy
• Maintain professional communication and timely documentation

What’s in it for you:

• 100% remote position for Oregon residents
• Great team culture with strong support and collaboration
• Competitive pay and full-time schedule
• Gain valuable experience with a leading national healthcare organization

Apply now for consideration with Chris M. at A-Line Staffing!

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