Job description

About iMPROve Health

iMPROve Health is a nonprofit healthcare organization based in Michigan and recognized as the state’s Medicare-designated Quality Improvement Organization. The company has been acknowledged by Crain’s Detroit Business as a Cool Place to Work for four consecutive years and named one of Modern Healthcare’s Best Places to Work in Healthcare.

With more than four decades of experience, the organization focuses on improving care across the full healthcare continuum through evidence-based, data-informed methods. Its services include medical consulting, clinical review, data analysis, impartial utilization review, dispute resolution, and peer review for federal agencies, Medicaid programs, public health organizations, healthcare facilities, private health plans, and other payers.

This role is fully remote and can be performed from anywhere within the United States. The organization emphasizes work-life balance, ongoing learning, and professional growth, and provides benefits such as medical, dental, and vision coverage, life insurance, short- and long-term disability, and a generous 401(k) match.

The team includes physicians, nurses, and experienced consultants who support providers with evidence-based best practices while remaining objective and independent. The goal is to improve healthcare quality, safety, and efficiency without delivering direct patient care.

About the Role

The company is looking for a detail-driven Registered Nurse to serve as an Independent Review Nurse. This part-time remote position requires a steady commitment of 20 hours per week during standard business hours, Monday through Friday, Eastern Time. Some evening, weekend, or holiday work may be needed to meet contractual deadlines.

In this position, you will conduct independent clinical reviews that support medical management, utilization review, external review, quality review, and related healthcare review programs. The ideal candidate brings solid clinical experience, sound judgment, strong analytical ability, and the discipline to deliver objective, evidence-based decisions in a fast-paced remote setting.

The role demands strong time management, accuracy, and consistency in meeting turnaround requirements while remaining aligned with regulatory and accreditation standards.

Schedule and Work Expectations

Part-time schedule of 20 hours per week
Work hours follow normal Monday to Friday business operations
Consistency in assigned shifts and review deadlines is essential
Availability for additional hours, evenings, weekends, and holidays may be required to meet business and contractual demands

Key Responsibilities

Carry out independent clinical case reviews in line with contract terms, evidence-based guidance, and applicable regulations
Examine medical charts and supporting records to reach objective, clinically appropriate conclusions
Complete assigned reviews within required turnaround timelines
Organize and prioritize multiple cases at once
Record findings accurately in electronic case systems and online portals
Draft clear, concise, well-supported written determinations
Ensure all outgoing review materials are accurate, complete, and submitted by deadline
Follow HIPAA, CMS, URAC, FISMA, and other relevant compliance standards
Contribute to quality checks, audits, and ongoing training efforts
Work with internal teams while preserving reviewer independence and neutrality
Support other review assignments and special projects as needed

Required Qualifications

Bachelor’s degree in nursing
Current unrestricted RN license in any U.S. state, or as required by the contract
At least 3 years of clinical nursing or related healthcare experience
Hands-on experience reviewing medical records and clinical documentation
Strong clinical assessment and critical thinking ability
Excellent attention to detail and organizational discipline
Ability to juggle multiple priorities while meeting deadlines consistently
Strong customer service mindset and professional communication skills
Ability to work independently in a remote setting
Strong verbal communication skills
Strong written communication skills, including experience writing in APA format

Preferred Experience

Background in utilization management, utilization review, case management, external review, or medical necessity review
Experience using evidence-based clinical guidelines and regulatory standards in decision-making
Familiarity with electronic case management platforms and healthcare portals

Technical Skills

Microsoft Office applications, including Word, Excel, Outlook, PowerPoint, and Teams
Electronic medical record systems
Case management software
Web-based healthcare portals
Project management platforms such as Asana
General office technology and remote collaboration tools

Success Traits

Reliable clinical judgment
Strong analytical and problem-solving ability
Clear and accurate written documentation
High attention to detail
Good time management
Dependability and accountability
Comfort adapting to shifting priorities
Commitment to privacy and regulatory compliance
Professional conduct and integrity

Work Environment

The job is carried out remotely from a professional home office located in the United States. A secure workspace and dependable high-speed internet connection are required to maintain confidentiality and productivity.

Why Join iMPROve Health

This role offers the chance to contribute meaningfully to healthcare quality and patient outcomes while working alongside a collaborative team of healthcare professionals. The organization values integrity, clinical excellence, continuous learning, and objective, high-quality review services.

If you are an experienced Registered Nurse interested in applying your expertise in a flexible part-time remote role, this position may be a strong fit.

Equal Opportunity

EOE/VET/Disability