Clinical Review Jobs

Support clinical review workflows at Telligen by coordinating medical information, communicating review decisions, and ensuring data integrity in a hybrid in-office role.

Provide focused, in-person disability exams and medical record reviews for Veterans as an NP or PA in Fargo, supporting the VA disability benefits process without treatment responsibilities.

Dane Street seeks board-certified PM&R and Pain Management physicians to serve as independent contract reviewers providing telework disability review opinions.

Experienced RN with utilization management and prior authorization expertise needed to validate and improve AI-driven prior authorization workflows at Innovaccer.

Holy Cross Hospital is hiring an on-site Registered Nurse Clinical Research Associate to support oncology clinical trials by coordinating patient recruitment, data collection, regulatory compliance, and safety reporting.

Rho is hiring a board-certified Psychiatrist to serve as a remote Medical Director responsible for medical monitoring, safety review, and clinical development input across global clinical trial programs.

Northwestern Medicine seeks a Senior Regulatory Coordinator to lead IRB submissions and regulatory oversight for complex stem cell transplant and cell therapy studies within the Autoimmune Diseases program.

Experienced physician needed to serve as Medical Director at a collaborative CRO, providing medical oversight, safety review, and scientific guidance across clinical programs.

Lead clinical review and care coordination for medically complex MassHealth members by supervising eligibility/authorization processes, interpreting regulations, and partnering with providers and state agencies.

Centinela Hospital Medical Center is hiring an RN Case Manager to coordinate inpatient care, perform concurrent review for medical necessity, and support cost-effective, high-quality patient outcomes.

Donor Network of Arizona is hiring an Organ Referral Liaison to manage HBV referrals, evaluate donor suitability, and coordinate family and hospital communications on the night shift.

Provide strategic regulatory leadership for U.S. advertising, promotion, and medical materials for high-priority products at Novartis' East Hanover site.

The Senior Scientific Writer will craft accurate, engaging scientific content and lead content strategy to amplify St. Jude’s research and clinical discoveries to diverse audiences.

A funded postdoctoral opportunity in nephrology to conduct health outcomes research, manage clinical datasets, and contribute to manuscripts and grant deliverables at the University of Kansas Medical Center.

Experienced child welfare supervisor sought to lead borough-level Clinical Consultation Program oversight and staff development for ACS Division of Child Protection.

Responsible for managing the contract lifecycle for clinical and professional services, ensuring accurate drafting, negotiation, and compliance across stakeholders at a top pediatric hospital.

Mass General Brigham is hiring a remote Clinical Review Specialist to perform pre-visit chart reviews, identify HCC/risk-adjustment opportunities, and educate providers to improve documentation accuracy.

American Specialty Health is hiring a licensed, experienced acupuncturist to serve remotely as Manager I — CQE Acupuncture, conducting medical necessity reviews and supporting clinical quality and credentialing activities.

ICON seeks a remote Clinical Research Associate to perform site qualification, monitoring, and close-out activities for ophthalmology clinical trials across the Northeast region.

A Clinical Liaison role at Lehigh Valley Health Network responsible for referral screening, insurance verification/authorization, bed management and coordination of admissions for the inpatient rehabilitation facility.

Northwestern Medicine is hiring a Clinical Quality Documentation Specialist (RN) to partner with clinical teams and leadership to improve documentation accuracy and clinical quality outcomes.

Work remotely as a Medical Coding Reviewer I at Centene, conducting clinical claim and record reviews to ensure accurate coding, compliance, and identification of billing issues.

A licensed RN with clinical operations and QA experience will manage clinical quality, conduct chart reviews and resolve patient escalations for Vida's virtual obesity care programs.

Experienced, licensed Physician needed to conduct comprehensive medical screenings and determine military medical eligibility at a USMEPCOM processing site in Lansing, MI for International SOS Government Medical Services.

Senior medical affairs leader needed to drive oncology/hematology strategy, clinical evidence generation, and cross-functional medical support for AbbVie's product portfolio in a hybrid San Francisco role.

Cogent Biosciences seeks an experienced Clinical Trial Manager to lead operational delivery of pivotal rare-disease and oncology trials for its precision kinase inhibitor programs.

Lead and support a growing home health clinical team in Topeka as an RN Clinical Supervisor, driving quality care, documentation accuracy, and staff development.

Experienced coding and clinical documentation specialist needed to lead quality audits, mortality and HAC/PSI reviews, and education initiatives across Northwestern Medicine's health system (remote, must reside in IL/IN/IA/WI).

Experienced oncology medical affairs leader needed to drive scientific strategy, clinical evidence generation, medical education, and safety oversight for AbbVie’s hematology/oncology programs on a hybrid schedule based in Mettawa, IL.

UMMS is hiring a PRN Clinical Documentation Specialist in Towson to ensure complete, accurate inpatient documentation that supports correct ICD-10 coding and high-quality clinical data.

Sutter Health is hiring a Physician Advisor to lead utilization review, support clinical documentation improvement, and guide level-of-care decisions at its Sacramento facility.

Humana seeks a licensed Texas DDS/DMD with clinical and utilization review experience to serve as Dental Director, providing clinical oversight of claims, appeals, policy development, and quality initiatives for its Texas member population.

Clinical Pharmacist (Utilization Management) to support PBM clinical operations by reviewing utilization requests, creating policy, and coordinating with prescribers and internal teams to drive safe, cost-effective medication access.

Centene seeks a board-certified MD/DO to serve as a Remote Medical Director for Georgia, providing clinical leadership for utilization management, quality improvement, and credentialing.

Mass General Brigham seeks an RN Supervisor, Utilization Management to lead and coach a clinical team conducting inpatient and outpatient utilization reviews while driving quality, productivity, and system improvements.

Experienced LVN/RN with utilization review background needed to perform clinical reviews, determine medical necessity, and collaborate with providers and case teams in a remote Utilization Management Nurse Reviewer role at Dane Street.

Provide primary-care medical evaluations and clinical decision-making for military applicants at the USMEPCOM MEPS facility in Oklahoma City as a Nurse Practitioner with Spectrum Healthcare Resources.

Provide in-person Compensation & Pension (C&P) medical exams for Veterans in Lubbock, TX with flexible scheduling, sign-on incentives, and competitive pay.

Prime Healthcare is hiring a CDS Trainee to conduct clinical documentation reviews and partner with care teams to optimize documentation for quality and reimbursement.

Lead and grow ARH's regional Utilization Review program by directing staff, ensuring compliance with regulatory standards, and optimizing patient care and resource utilization.

Lead clinical science and program-level strategy for oncology development at Coherus, driving trial design, data review, regulatory interactions, and scientific communications.

Lead HCP marketing strategy and messaging for a major oncology brand, translating complex clinical data into high-impact, compliant materials that drive provider engagement and support field teams.

Remote Clinical Support Coordinator (Certified Medical Assistant) role reviewing claims and preparing DBQ orders for timely provider completion at MPF Federal.

Use your clinical expertise to translate complex patient records into accurate longitudinal data that accelerates rare disease research at a fast-growing AI-health startup.

Lead clinical science strategy and program execution for Janux's ARM immunotherapy trials as the Director, Clinical Science based in San Diego.

Daybreak Health is seeking a part-time Supervising Psychiatrist to provide tele-supervision and clinical mentorship to PMHNPs across Kentucky to advance youth mental health care access.

Prime Healthcare Saint Mary of Nazareth is hiring an RN Assessment (MDS) Coordinator to lead resident comprehensive assessments, manage MDS/RUGs reporting, and coordinate the interdisciplinary care team.

Experienced board-certified Diagnostic Radiology physicians are needed to provide objective medical necessity reviews and advisory opinions for IMEs and utilization review on a flexible, per-case basis.

Provide in-person disability assessments and medical documentation for U.S. Veterans in El Paso, supporting the VA benefits evaluation process as a licensed Clinical Psychologist.

Support Dr. Aize Cao’s research team as an on-site Research Assistant conducting clinical data collection, managing datasets, and performing preliminary analyses to advance studies in maternal health and substance use.