Remote NP- Clinical Review & Oversight

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