Nurse Reviewer (Registered Nurse) - Remote in US

Gainwell is seeking a talented Nurse Reviewer (RN) to perform clinical reviews, interpret medical records, and apply critical thinking to assess appropriateness and reasonableness of care. The role involves accessing proprietary systems, documenting findings, and providing policy/regulatory support for determination.

Requirements

• Active, unrestricted RN licensure in the U.S. and primary state of residence
• Minimum of 5+ years clinical experience in an inpatient hospital setting
• Minimum of 2+ years utilization review or claims auditing experience
• Experience with Milliman or InterQual criteria

Benefits

• Health benefits (medical, dental, vision)
• Paid time off
• 401(k) employer match
• Educational assistance