Remote NP – Clinical Review & Oversight | Personal NPI Credentialing Required

Overview

• Fully remote, asynchronous 1099 contractor role.
• No direct patient interaction or face-to-face contact.
• Flexible scheduling based on caseload volumes.

Credentialing Requirements

• Individual credentialing under personal NPI with major payers (employer credentialing does not qualify).
• Required payers: UnitedHealthcare (UHC), Blue Cross Blue Shield (BCBS), Aetna, Cigna, and Medicare.

Role Responsibilities

1. Patient Record Oversight (RECAP)

• Serve as rendering provider for clinical services and billing.
• Provide clinical review of patient history summary programs prior to delivery.
• Ensure adherence to program standards and quality expectations.

2. Gaps-in-Care Review & Sign-Off (RESOLVE)

• Review gaps-in-care plans prepared by the clinical team for accuracy.
• Verify care gaps are clinically supported by the medical record.
• Confirm preventive screenings, chronic condition management, medications, behavioral health, and social determinants of health.
• Edit, flag discrepancies, and finalize approved care plans.

Required Qualifications

• Active, unrestricted Nurse Practitioner license (multi-state preferred).
• Board certification (FNP, AGNP, or equivalent).
• Comfort with remote clinical oversight and asynchronous workflows.
• Familiarity with chronic disease management, preventive care, and quality measure frameworks (HEDIS, USPSTF).
• Proficiency with cloud-based clinical platforms and Microsoft Suite.