Remote Clinical Review Coordinator Jobs
Remote clinical review coordinator jobs are in active demand across the U.S., with remote-first firms, distributed healthcare organizations, and managed care companies hiring for these roles right now. Employers hiring remotely right now include Optum, CorVel Corporation, and Enjoin. See the openings below and apply to the ones that match your experience.
Find JobsOverview
Showing 5 of 16+ Remote Clinical Review Coordinator jobs
Position Purpose: Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance with national standards, contractual requirements, and a member's benefit coverage. Provides recommendations to the appropriate medical team to promote quality and cost effectiveness of medical care.
Key Details: Remote Role. Texas RN License Required.
- Performs medical necessity and clinical reviews of authorization requests to determine medical appropriateness of care in accordance with regulatory guidelines and criteria
- Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care
- Coordinates as appropriate with healthcare providers and interdepartmental teams, to assess medical necessity of care of member
- Escalates prior authorization requests to Medical Directors as appropriate to determine appropriateness of care
- Assists with service authorization requests for a member’s transfer or discharge plans to ensure a timely discharge between levels of care and facilities
- Collects, documents, and maintains all member’s clinical information in health management systems to ensure compliance with regulatory guidelines
- Assists with providing education to providers and/or interdepartmental teams on utilization processes to promote high quality and cost-effective medical care to members
- Provides feedback on opportunities to improve the authorization review process for members
- Performs other duties as assigned
- Complies with all policies and standards
Education/Experience: Requires Graduate from an Accredited School of Nursing or Bachelor’s degree in Nursing and 2 – 4 years of related experience.
Clinical knowledge and ability to analyze authorization requests and determine medical necessity of service preferred.
Knowledge of Medicare and Medicaid regulations preferred.
Knowledge of utilization management processes preferred.
License/Certification:
- For Superior Health Plan: RN license required
Pay Range: $27.02 - $48.55 per hour
At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act.
Position Purpose: Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance with national standards, contractual requirements, and a member's benefit coverage. Provides recommendations to the appropriate medical team to promote quality and cost effectiveness of medical care.
Key Details: Remote Role. Texas RN License Required.
- Performs medical necessity and clinical reviews of authorization requests to determine medical appropriateness of care in accordance with regulatory guidelines and criteria
- Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care
- Coordinates as appropriate with healthcare providers and interdepartmental teams, to assess medical necessity of care of member
- Escalates prior authorization requests to Medical Directors as appropriate to determine appropriateness of care
- Assists with service authorization requests for a member’s transfer or discharge plans to ensure a timely discharge between levels of care and facilities
- Collects, documents, and maintains all member’s clinical information in health management systems to ensure compliance with regulatory guidelines
- Assists with providing education to providers and/or interdepartmental teams on utilization processes to promote high quality and cost-effective medical care to members
- Provides feedback on opportunities to improve the authorization review process for members
- Performs other duties as assigned
- Complies with all policies and standards
Education/Experience: Requires Graduate from an Accredited School of Nursing or Bachelor’s degree in Nursing and 2 – 4 years of related experience.
Clinical knowledge and ability to analyze authorization requests and determine medical necessity of service preferred.
Knowledge of Medicare and Medicaid regulations preferred.
Knowledge of utilization management processes preferred.
License/Certification:
- For Superior Health Plan: RN license required
Pay Range: $27.02 - $48.55 per hour
At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act.
See All 16 Remote Clinical Review Coordinator Jobs
Find roles that match your experience and apply in just a few clicks.
Find JobsRemote Clinical Review Coordinator Job Market
Who's Hiring
Top Industries Hiring
- Technology & Software
- Insurance
- Consulting & Professional Services
What Employers Look For
The qualifications that appear most often in remote clinical review coordinator jobs.
- Active registered nurse, licensed clinical social worker, or equivalent clinical license
- Experience applying InterQual or MCG evidence-based clinical criteria
- Knowledge of utilization management, prior authorization, or case management processes
- Proficiency with electronic health records and payer-specific review platforms
- Familiarity with Medicare, Medicaid, or commercial insurance coverage guidelines
- Strong written documentation skills for denial letters and clinical rationale reports
Tips for Your Remote Clinical Review Coordinator Job Search
Apply early to remote roles that fit
Migrate Mate lists remote clinical review coordinator openings from across the U.S. in one place, so you can find roles that match your clinical background and apply directly without sorting through unrelated postings.
Prove you can work clinical workflows remotely
Remote employers want evidence you can manage case queues, apply InterQual or Milliman criteria, and document decisions without in-person supervision. Quantify your review volume and turnaround accuracy on your resume to show you've done it independently.
Signal async communication skills upfront
Remote clinical review teams rely on written handoffs through platforms like Epic, Jira, or case management portals. Mention specific tools you've used for async clinical communication in both your resume and your cover letter so hiring teams don't have to guess.
Prepare for remote behavioral interview questions
Remote clinical review interviews consistently probe how you handle ambiguous cases without a supervisor nearby, how you prioritize a full queue independently, and how you escalate when criteria don't clearly apply. Prepare specific examples for each scenario before your first screen.
Remote Clinical Review Coordinator Jobs: Frequently Asked Questions
How do I get a remote clinical review coordinator job?
Target companies that run distributed clinical operations teams, including managed care organizations, utilization management firms, and health plan administrators that have built fully remote review workflows. Remote employers screen heavily for self-direction, precise written communication, and familiarity with clinical criteria tools like InterQual or Milliman. Candidates who can demonstrate independent case review experience and comfort with async communication tools consistently stand out.
Which companies hire remote clinical review coordinators?
Remote clinical review coordinator roles are posted by Optum, CorVel Corporation, and Enjoin and others right now, based on current remote listings on Migrate Mate as of November 2026. These include remote-first managed care companies, distributed utilization management firms, and health insurance organizations that have fully embedded clinical review into distributed team structures.
Can you get a remote clinical review coordinator job with no experience?
Yes, but remote entry-level clinical review coordinator roles are harder to land because employers expect you to manage case queues and clinical criteria independently from day one. Your best opening is through remote-friendly utilization management companies or telehealth-adjacent firms that hire new graduates. Showing clinical coursework, familiarity with ICD coding, and comfort with digital documentation tools can substitute for direct experience.
Do you need a degree for remote clinical review coordinator jobs?
Not always. Many remote employers require a clinical background, such as an RN license or a health information credential, but don't mandate a four-year degree beyond that credential. What remote hiring teams weigh most is demonstrated clinical judgment, accurate documentation under productivity standards, and the ability to apply evidence-based criteria without direct supervision.
Which industries hire the most remote clinical review coordinators?
Most remote clinical review coordinator openings sit in Technology & Software, Insurance, and Consulting & Professional Services, per current remote listings on Migrate Mate as of November 2026. These sectors hire remotely because utilization review, prior authorization, and care coordination workflows translate cleanly to distributed teams operating across multiple time zones and health plan regions.
See All 16 Remote Clinical Review Coordinator Jobs
Find roles that match your experience and apply in just a few clicks.
Find Jobs