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Remote Nurse Reviewer: Medicaid Medical Necessity
Remote / Online - Candidates ideally in
Lower Merion, Montgomery County, Pennsylvania, USA
Listed on 2026-07-28
Lower Merion, Montgomery County, Pennsylvania, USA
Listing for:
Healthcare Quality Strategies, Inc. (HQSI)
Part Time, Remote/Work from Home
position Listed on 2026-07-28
Job specializations:
-
Nursing
Healthcare Nursing, RN Nurse
Job Description & How to Apply Below
Healthcare Quality Strategies, Inc. is seeking a Nurse Reviewer for a part-time, remote role (20-30 hours per week).
The RN will perform medical necessity reviews and policy reviews for Medicaid claims, working with the team to ensure timely completion and high-quality determinations. The ideal candidate holds an active RN license (BSN preferred), has experience with ICD-10, CPT, HCPCS, Inter Qual/MCG criteria, and strong documentation skills.
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