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Clinical Review Nurse - Concurrent Review

Spectraforce Technologies

United States, North Carolina, Raleigh

500 West Peace Street (Show on map)

Sep 11, 2026

Position Title: Clinical Review Nurse - Concurrent Review

Work Location: Remote - Any US State

Assignment Duration: 12 months

Work Arrangement: Fri-Sat-Sun-Mon 8:30 am CST - 6 pm CST

Responsibilities:

Working within a highly engaged team remotely, with ongoing support to produce denial correspondence based off the advisor review that is in easy-to-understand language to the member and adheres to the NCQA and state standards. There may be at times, OT expectations based on business needs. This team does work holidays, which are rotated amongst the team members

Candidate Requirements
Education/Certification	Required: Requires graduated from an accredited school of nursing or A.D. or bachelor's in nursing	Preferred: 2-4 years of related experience
Licensure	Required: LPN or RN, active in any state	Preferred: Compact
Years of experience required: Must haves: Minimum 1 year nursing experience. Live anywhere in the U.S. Nice to haves: Knowledge of Medicare and Medicaid regulations; Knowledge of utilization management Disqualifiers: Performance indicators: Metric driven in production and quality
Top 3 must-have hard skills stack-ranked by importance	1	Ability to critically think
2	Ability to effectively use Microsoft OneNote and Word
3	Ability to work remotely, i.e. meet production deadlines; quality metrics
Candidate Review & Selection
Shortlisting process Candidate review & selection Interview information Onboard process and expectations	Projected Manager Candidate Review Date:	1-2 days post shortlisting
Type of Interviews:	1 teams meeting interview
Required Testing or Assessment (by Vendor):	NO