[Hiring] Independent Review Nurse @iMPROve Health

Role Description

iMPROve Health is seeking an experienced and detail-oriented Registered Nurse to join our team as an Independent Review Nurse (IRN). This is a part-time remote position requiring a consistent commitment of 20 hours per week scheduled during normal business hours (Monday–Friday, Eastern Time), with additional after hours, weekend, and holiday hours, as needed to meet contractual deadlines.

In this role, you will perform independent clinical reviews supporting medical management, utilization review, external review, quality review, and other healthcare review programs. The ideal candidate is an experienced RN with strong clinical judgment, exceptional analytical skills, and the ability to make objective, evidence-based determinations while working in a fast-paced remote environment.

This position requires excellent time management, accuracy, and a commitment to meeting contractual turnaround times while maintaining compliance with regulatory and accreditation requirements.

Qualifications

• Bachelor's degree in nursing
• Excellent verbal communication skills
• Excellent written communication skills, to include experience documenting in APA format
• Current, unrestricted Registered Nurse (RN) license in any U.S. state (or as required by contract)
• Minimum of three (3) years of clinical nursing or related healthcare experience
• Experience reviewing medical records and clinical documentation
• Strong clinical assessment and critical thinking skills
• Exceptional attention to detail and organizational skills
• Ability to manage multiple priorities while consistently meeting deadlines
• Strong customer service and professional communication skills
• Ability to work independently in a remote environment

Requirements

• Experience in utilization management, utilization review, case management, external review, or medical necessity review (preferred)
• Experience applying evidence-based clinical guidelines and regulatory requirements (preferred)
• Experience working with electronic case management systems and healthcare portals (preferred)

Benefits

• 100% remote position
• Flexibility to work from anywhere in the United States
• Work/life balance
• Professional development and continuing education opportunities
• Medical, dental, vision, life insurance
• Short- and long-term disability
• Generous 401(k) match

Work Environment

This position is performed remotely from a professional home office within the United States. Candidates must have reliable high-speed internet access and a secure workspace that supports confidentiality and productivity.

What You'll Do

• Perform independent clinical reviews in accordance with contract requirements, evidence-based guidelines, and regulatory standards
• Review medical records and supporting documentation to make objective, clinically sound determinations
• Complete assigned case reviews accurately and within required turnaround times
• Prioritize incoming review assignments and manage multiple cases simultaneously
• Document review findings accurately in electronic case management systems and web-based portals
• Prepare clear, concise, and well-supported written determinations
• Ensure outgoing review documentation is complete, accurate, and submitted within contractual deadlines
• Maintain compliance with HIPAA, CMS, URAC, FISMA, and other applicable regulatory requirements
• Participate in quality assurance activities, audits, and ongoing training
• Collaborate effectively with internal teams while maintaining reviewer independence and objectivity
• Assist with additional review activities and projects as business needs require

What Makes You Successful

• Sound clinical judgment
• Strong analytical and problem-solving abilities
• Excellent written documentation skills
• Accuracy and attention to detail
• Effective time management
• Accountability and reliability
• Ability to adapt to changing priorities
• Commitment to confidentiality and regulatory compliance
• Professionalism and integrity

Why Join iMPROve Health?

At iMPROve Health, you'll have the opportunity to make a meaningful impact on healthcare quality and patient outcomes while working with a collaborative team of healthcare professionals. We value integrity, clinical excellence, continuous learning, and a commitment to delivering objective, high-quality review services.