DirectShifts

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

DirectShifts

|Visit Website

Location

Anywhere

Job Type

PARTTIME

Salary

$10 - $15 / hour

Remote

Yes

Role Type

NP

Job Description

Overview We are seeking experienced Nurse Practitioners to join our clinical network as 1099 independent contractors. NPs in this role serve as rendering providers supporting our patient record review and gaps-in-care programs. This is a fully remote, documentation-based role with no direct patient interaction. Work is completed asynchronously within our clinical platforms, with scheduling flexibility to accommodate varying caseload volumes. Credentialing Requirements Candidates must be individually credentialed with major payers under their personal NPI. Credentialing through a current or former employer does not satisfy this requirement. Required payers: • UnitedHealthcare (UHC) • Blue Cross Blue Shield (BCBS) — varies by state • Aetna • Cigna • Medicare Role Responsibilities 1. Patient Record Oversight (RECAP) The NP serves as a rendering provider for our patient history summary program. While the clinical operations team manages record retrieval, summary preparation, and initial quality review, the NP preforms clinical review of completed summaries to ensure accuracy and completeness. • Serve as rendering provider enabling billing for clinical services • Provide clinical review of patient RECAP summaries prior to delivery • Providing clinical oversight to 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 and appropriateness • Verify that identified care gaps are clinically supported by the patient's medical record • Confirm relevant areas including preventive screenings, chronic condition management, medications, behavioral health, social determinants of health, and recommended interventions • Make edits or flag discrepancies as needed before sign-off • Finalize and sign approved care plans within the clinical platform • No direct patient contact or face-to-face interaction involved Required Qualifications • Active, unrestricted Nurse Practitioner license (multi-state preferred) • Board certification (FNP, AGNP, or equivalent) • Individual credentialing with major commercial payers and Medicare under personal NPI • Comfort with remote clinical oversight and asynchronous documentation workflows • Familiarity with chronic disease management, preventive care, and quality measure frameworks (e.g., HEDIS, USPSTF) • Proficiency with cloud-based clinical platforms and Microsoft Suite DirectShifts is an Equal Opportunity Employer All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status, or any other characteristic protected by law. Your Right to Work In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire.

See more jobs from US

Field Remote Nurse Practitioner/ Physician Assistant (hospice/palliative care experience preferred)

Alignment Healthcare

PA
View Job

Authorization Nurse, RN (Hybrid - Remote Considered) - 26-49

PriMed Management Consulting

RN
View Job

Licensed Vocational Nurses (LVN's) Needed

Aveanna Healthcare

LPN/LVN
View Job

[Hiring] Prior Authorization Nurse Associate LPN/LVN @CVS Health

CVS Health

LPN/LVN
View Job

Prior Authorization Licensed Practical Nurse

US Tech Solutions

LPN/LVN
View Job

(RN) Remote Care Manager - SC based

Molina Healthcare

RN
View Job

Virtual Family Practice Nurse Practitioner

Medix

NP

$65 $75 hour

View Job

Remote Telemedicine Nurse Practitioner — Patient Messaging & Consult Completion

Wasef Health

NP

$75,000 $150,000 year

View Job