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Remote Jobs with RN License Certification

36 fresh jobs found

Oncology Nurse (RN) Case Management Lead Analyst - Evernorth Health Services - Remote
Pennsylvania Work at Home

The Cigna Group

Oncology Nursing Disease Prevention Shared Decision Making Digital Messaging Health promotion Internet Research Clinical Acumen Behavior Change Medical management +30

Senior Mid Full Time

USD 75K+

In Home Nurse Care Manager
Phoenix, AZ

Included Health

Health outcomes improvement Multidisciplinary teamwork Social Determinants of Health Chronic Disease Management In-person care Specialty care Manual Dexterity Community Health Disease Management +30

USD 25K+

RN II, Primary Nurse Care (Oncology)
Hopewell, NJ

Horizon Blue Cross Blue Shield of New Jersey

Oncology Care Health Care Delivery Patient advocacy Clinical assessment Utilization management Quality improvement RN Care management Telehealth +1

USD 76K+

Case Manager RN- Maternity/Fertility
Work At Home-Arizona

Maternity Telephonic case management Ob-gyn Infertility Women's Health RN license Clinical resources Clinical Tools Holistic approach +23

USD 54K+

RN- Maternity Nurse Case Manager-Remote
Pennsylvania Work at Home

The Cigna Group

Disease Prevention Shared Decision Making Digital Messaging Health promotion Internet Research Behavior Change Clinical Acumen Medical management Cultural Sensitivity +27

USD 75K+

Case Manager RN- Maternity
Work At Home-Arizona

Holistic Assessment Maternity Care Women's Health RN license Clinical resources Clinical Tools Holistic approach Policies and procedures Data Review +23

USD 54K+

UM Nurse-Compact RN License Required
Remote US

Interpreting Criteria Medical Services Health Plan Experience Clinical Nursing Home Health Rehabilitation Acute care Registered Nurse Consumer Experiences +37

USD 69K+

Case Manager
High Point-4050 Piedmont Parkway

Telephonic case management Emergency department RN license Long Term Care Clinical resources Holistic approach Clinical Tools Data Review Policies and procedures +26

USD 54K+

Clinical Quality Nurse Reviewer, Sr. Specialist - (RN Remote in US)
Any city, NC, US, 99999

Gainwell Technologies

Clinical quality review InterQual criteria Chart Audits Clinical criteria guidelines Productivity standards Medical Record Review RN license InterQual Clinical Criteria +28

Senior Full Time

USD 64K+

Oncology Nurse (RN) Case Management Lead Analyst -Evernorth Health Services - Remote
Pennsylvania Work at Home

The Cigna Group

Disease Prevention Oncology Nursing Shared Decision Making Digital Messaging Health promotion Telephonic Communication Internet Research Behavior Change Clinical Acumen +31

Senior Mid Full Time

USD 75K+

DRG Nurse Quality Auditor, Sr. Specialist - Remote in US
Any city, OK, US, 99999

Gainwell Technologies

CC Education content development DRG auditing MCC Coding reviews Payment methodologies DRG validation Training Initiatives APR-DRG +38

Senior Full Time

USD 64K+

Bilingual Spanish Telephonic RN Case Manager (Must have California License)
Remote-US, California, United States

Alignment Health

Health Care Management Resource Utilization Bilingual English and Spanish Chronic Condition Management RN license Care Coordination RN Clinical Experience Care management +12

USD 79K+

Appeals Review Nurse
Remote

NCCN Medical decision support tools Level of care reviews Medical necessity reviews Milliman care guidelines Evidence-Based Guidelines InterQual MCG Clinical Guidelines +16

Entry Mid Full Time

USD 70K+

Senior Medicaid HEDIS Data Professional
Remote US

Healthcare quality improvement Healthcare quality NCQA HEDIS Analyzing ETL Processes Microsoft Office Applications Data Warehouse Simulation +56

Senior Full Time

USD 71K+

Case Manager RN
Work At Home-Colorado

Transplant Critical care RN license RN licensure Clinical Practice Utilization management RN Managed Care Health care +8

USD 60K+

RN- Nurse Case Manager-Chronic Kidney Disease- Remote
Pennsylvania Work at Home

The Cigna Group

Shared Decision Making Digital Messaging Health promotion Behavior Change Internet Research Clinical Acumen Medical management Cultural Sensitivity Health Services +27

USD 75K+

Advanced Practice Clinician, Care Anywhere
Reno, Nevada, United States

Alignment Health

Hospice care Health Screenings Physician Assistant Geriatric care Palliative Care Clinical assessments Home Care Nurse Practitioner RN +7

USD 135K+

Utilization Review Nurse
Remote

Level of care reviews Medical necessity reviews Evidence-Based Guidelines Clinical Guidelines Acute care RN licensure Clinical Practice Clinical Review Utilization Review +11

USD 70K+

RN Case Manager- NICU- Remote
Pennsylvania Work at Home

The Cigna Group

Digital Messaging Shared Decision Making Behavior Change Health promotion Internet Research Clinical Acumen Medical management Cultural Sensitivity Health Services +27

USD 75K+

RN or PT- Musculoskeletal (MSK) Care Advocate-Remote
Arizona Work at Home

The Cigna Group

Health Care Knowledge Wellness Coaching Cognitive behavioral coaching Technology navigation Digital Messaging Cultural humility Digital Communication Goal setting Clinical Acumen +22

USD 75K+

Associate Manager, Clinical Review Nurse (Remote)
Any city, TX, US, 99999

Gainwell Technologies

Clinical review judgment APR-DRG MS-DRG CCS Quality Metrics DRG CPC Clinical Criteria RN license +36

Senior Mid Full Time

USD 69K+

Behavioral Health Specialist - Licensed (Remote)
PA, Working at Home - Pennsylvania

Highmark Health

Healthcare navigation Condition Management Self-Management Clinical assessment Cognitive Behavioral Therapy Motivational interviewing Healthcare services Behavioral health Case Management +10

USD 57K+

Complex Case Manager - RN (Remote)
PA, Working at Home - Pennsylvania

Highmark Health

Disease Processes Condition Management Gastroenterology Care Planning Cultural Competency Analytic Clinical Judgment RN MS Excel +13

Senior Mid Full Time

USD 57K+

RN-Oncology Nurse Case Manager- Remote
Arizona Work at Home

The Cigna Group

Digital Messaging Shared Decision Making Behavior Change Health promotion Internet Research Medical management Clinical Acumen Telephonic Communication Motivational interviewing +25

USD 75K+

RN- Complex Nurse Case Manager- Remote
Pennsylvania Work at Home

The Cigna Group

Digital Messaging Shared Decision Making Behavior Change Health promotion Internet Research Medical management Clinical Acumen Cultural Sensitivity Health Services +27

USD 75K+

Holistic Health Specialist
Richardson Texas HQ (1001 E. Lookout Drive)

Health Care Service Corporation

MCG Certification Wellness education Milliman guidelines Condition Management Medical Management Policies Lotus Notes Database experience Coordination of care RN license +25

USD 58K+

Case Manager RN (Remote)
Work At Home-New York

Home health care coordination Proprietary applications Telework Navigating multiple systems RN license Clinical resources Holistic approach Clinical Tools Home Health +37

USD 66K+

Theory Course Coordinator for the DNP Program   - SPRING '25
Baltimore, MD, 21205 Jo Johns Hopkins University

Online Platforms Canvas Evidence-based practice Professionalism Digital Tools Nursing Teaching Feedback Writing +7

KN 88K+

Complex Case Manager RN Pediatric - (Remote)
PA, Working at Home - Pennsylvania

Highmark Health

Pediatric case management Condition Management Dialectical behavior therapy Disease Processes Care Plan Development Cognitive Behavioral Therapy Cultural Competency Motivational interviewing Clinical Judgment +15

Senior Mid Full Time

USD 57K+

Group Health Operations Manager (RN/LPN)
United States - Remote

Insurance Setting Staffing Management Long-term disability LPN Utilization Review Peer review Insurance Claims Computer literacy RN +13

USD 75K+

Bilingual Spanish Telehealth RN Case Manager, SNP (Must Have California RN License)
Remote-US, California, United States

Alignment Health

Health Care Management Resource Utilization Bilingual English and Spanish Chronic Condition Management Care Plan Development Care Coordination RN Care management Patient Education +12

USD 77K+

Clinical Reviewer-Immediate Advocacy Discharge Assistance, RN (Remote)
United States - Remote

Medical record organization Action plans Medical record abstracting Disease Processes Healthcare Regulations Clinical assessment Medical Records Public Sector RN +15

USD 44K+

Clinical Reviewer-Immediate Advocacy (RN/LCSW)-Remote
United States - Remote

Medical record abstracting Medical Record Review Rehabilitation Prior authorization Clinical assessment Public Sector Medical Records RN Clinical Experience +16

USD 44K+

Clinical Reviewer-Immediate Advocacy/Quality of Care (RN), Remote
United States - Remote

Medical record abstracting Medical Record Review Clinical Review Clinical assessment Public Sector Medical Records Healthcare Knowledge RN Care management +12

USD 44K+

Clinical DRG Auditor (Remote Nurse)
Any city, NC, US, 99999

Gainwell Technologies

Clinical review judgment HMS proprietary systems DRG validation AP-DRG Internet browsers MS-DRG CCS Productivity standards Coding certification +49

Senior Mid Full Time

USD 84K+

Nurse Reviewer, Appeals and Hearings (Remote)
Any city, KY, US, 99999

Gainwell Technologies

Appeals process Clinical criteria guidelines MCG criteria InterQual criteria Medical record coding Cross-training CCS Coding certification InterQual +26

USD 64K+

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