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Role Description

We are seeking an experienced and highly skilled Nurse Consultant to provide clinical expertise, strategic guidance, and professional insight across our healthcare programs and services. In this fully remote role, you will leverage your nursing knowledge to evaluate clinical information, enhance patient care processes, support data-driven decision-making, and collaborate with multidisciplinary teams.

The ideal candidate is analytical, detail-oriented, and an effective communicator who thrives in an independent, fast-paced virtual environment.

• Review and evaluate clinical documentation, medical records, and patient data to ensure accuracy, quality, and regulatory compliance
• Provide expert nursing consultation and clinical guidance to internal teams, clients, and external stakeholders
• Support case management, utilization review, care coordination, and quality improvement initiatives as needed
• Conduct clinical assessments, triage, and nurse consultations via phone and virtual platforms
• Identify trends in patient outcomes, care delivery, and clinical performance to recommend improvements
• Develop clinical summaries, reports, and evidence-based recommendations
• Collaborate with physicians, nursing staff, allied health professionals, and administrative teams
• Ensure compliance with clinical standards, organizational policies, and applicable regulations
• Participate in audits, training sessions, and process improvement initiatives
• Maintain patient confidentiality and ensure full compliance with HIPAA and privacy regulations

Qualifications

• Active, unrestricted Registered Nurse (RN) license (state-specific or compact, as applicable)
• Minimum of 3 years of clinical nursing experience (e.g., acute care, telehealth, case management, or specialty practice)
• Strong knowledge of evidence-based practice, clinical guidelines, and healthcare regulations
• Excellent critical thinking, documentation, and communication skills
• Ability to work independently in a remote setting with strong time-management and organizational skills
• Proficiency with EHR systems, telehealth platforms, and standard office software

Requirements

• Bachelor of Science in Nursing (BSN) or higher
• Experience in utilization review, quality improvement, risk management, insurance, or legal nurse consulting
• Relevant certifications (e.g., CCM, CPHQ, LNC, URAC or similar)
• Knowledge of reimbursement models, coding principles, and managed care processes

Core Competencies

• Advanced clinical judgment and nursing expertise
• Strong analytical and problem-solving abilities
• Clear, professional written and verbal communication
• Patient-centered and ethical decision-making
• Effective collaboration across multidisciplinary teams
• Adaptability and accountability in a remote work environment

Benefits

• 401(k)
• 401(k) matching
• Bonus based on performance
• Dental insurance
• Flexible schedule

Company Description

This is a remote position.