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Remote Jobs with RN License Certification

45 fresh jobs found

Quality Improvement Abstractor
Remote-TN, United States

Centene Corporation

CHIPRA Quality Initiatives Quality measures Data Abstraction Ncqa standards Microsoft Applications HEDIS Medical Coding Microsoft Access +17

USD 95K+

Chronic Care Management Registered Nurse (Remote)
Remote

Vesta Healthcare

Remote patient care Partnerships with home care agencies Mobile technologies Care Plan Development Data Integrations Remote patient monitoring Home Care Nurse Practitioner Chronic care management +17

USD 85K+

Community Liaison
Remote-LA, United States

Centene Corporation

Outreach coordination Substance use Accreditation Community Health Substance Use Disorder Social services Social Work Community Engagement Stakeholder communication +33

USD 55K+

Clinical Review Nurse - Prior Authorization
Getzville-105 Crosspoint Pkwy (11106), United States

Centene Corporation

Clinical reviews Authorization requests Health management Health management systems Medical appropriateness Medicaid regulations Clinical Review Medical necessity Acute care +18

USD 95K+

Supervisor, Care Management
Remote-WI, United States

Centene Corporation

Member Outreach Team Supervision Healthcare benefits Performance Evaluation Referrals Procedures Care Coordination Audits Care management +15

USD 85K+

Prior Authorization Utilization Review - PASRR (Remote Nurse)
Any city, TX, US, 99999

Gainwell Technologies

Functions Utilization Review Claims Clinical expertise RN Case Management Nursing Medicaid Medical +17

USD 65K+

Senior Care Manager (RN)
Remote-NY, United States

Centene Corporation

Service planning Healthcare outcomes Service coordination Care Plans Service plans Healthcare benefits Telephonic Outreach Referrals Community Resources +22

Senior Mid Full Time

USD 73K+

Nurse Care Manager, Adult
Arizona

Included Health

Medical record systems Acute case management Telephonic care Spanish Speaking In-person care Specialty care Disease Management Manual Dexterity Urgent care +23

Senior Mid Full Time

USD 25K+

Nurse Care Manager, Adult
Utah

Included Health

Medical record systems Acute case management Telephonic care Spanish Speaking In-person care Specialty care Disease Management Manual Dexterity Urgent care +23

Senior Mid Full Time

USD 25K+

Nurse Care Manager, Adult
Idaho

Included Health

Medical record systems Acute case management Telephonic care Spanish Speaking In-person care Specialty care Disease Management Manual Dexterity Urgent care +23

Senior Mid Full Time

USD 25K+

RN Clinical Review Nurse - Concurrent Review
Remote-CA, United States

Centene Corporation

Medicaid regulations Clinical Review Medical necessity Acute care Discharge planning Health Services Medical management Clinical knowledge Utilization management +9

USD 93K+

Care Manager (RN)
Remote-FL, United States

Centene Corporation

Healthcare outcomes Home outreach Personalized care plans Care Plans Resource support Digital Outreach Service plans Service Assessment Foster care +21

USD 55K+

Clinical Review Clinician - Appeals
Remote-NY, United States

Centene Corporation

Clinical reviews Appeals processing Clinical data analysis Interdepartmental Collaboration Ncqa standards Medicaid regulations Appeals Clinical Review Medical necessity +19

USD 52K+

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

The Cigna Group

Shared Decision Making Oncology nursing Disease Prevention Nurse Case Management Digital Messaging Health promotion Behavior Change Internet Research Telephonic Communication +32

Senior Mid Full Time

USD 76K+

TeleHealth Registered Nurse (Registry)
Remote-TX, United States

Centene Corporation

Health management Care Planning Triage Home Health Patient Assessment Procedures Health Services Medical management Clinical knowledge +10

USD 95K+

Clinical Case Manager Behavioral Health
Work At Home-Texas, United States

Community resource identification Provider coordination Bilingual Spanish and English Clinical Tools RN license Data Review Care Planning Telephonic Communication Crisis Intervention +32

USD 60K+

Senior Specialist- Online NCLEX Readiness
Remote, REMOTE, United States

Adtalem Global Education

Personalized Remediation Virtual Lab Coordination NCLEX-RN Preparation Academic Coaching Physician Assistant Studies Nursing Practice Academic Support Health Professions Academic Leadership +28

Senior Full Time

USD 53K+

Clinical Appeals & Denials Manager
Remote, MD, United States

Billing Accuracy Medical record reviews Denials management Clinical appeals RN license Intelligent Automation Workflow Orchestration Workflow Optimization Revenue Cycle +21

USD 69K+

RN Case Manager- NICU- Remote
Pennsylvania Work at Home, United States

The Cigna Group

Shared Decision Making Disease Prevention Digital Messaging Health promotion Behavior Change Internet Research Cultural Sensitivity Clinical Acumen Motivational interviewing +28

USD 76K+

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

The Cigna Group

Shared Decision Making Disease Prevention Nurse Case Management Digital Messaging Health promotion Behavior Change Internet Research Telephonic Communication Cultural Sensitivity +28

Senior Mid Full Time

USD 76K+

RN Nurse Case Management Lead Analyst - Work from Home, Anywhere, USA
Pennsylvania Work at Home, United States

The Cigna Group

Myndshft Nimble learning Clinical criteria review Cover My Meds Nurse Case Management Analytics Reporting Database navigation Decision quality Medical necessity +26

Senior Full Time

USD 76K+

RN-Oncology Nurse Case Manager- Remote
Arizona Work at Home, United States

The Cigna Group

Shared Decision Making Disease Prevention Digital Messaging Health promotion Behavior Change Internet Research Telephonic Communication Clinical Acumen Motivational interviewing +26

USD 76K+

Care Manager (RN)
Remote-AR, United States

Centene Corporation

Healthcare outcomes Home outreach Personalized care plans Care Plans Resource support Digital Outreach Service plans Service Assessment Foster care +19

USD 54K+

Urgent Care Nurse Practitioner
Minnesota

Included Health

Health management Diagnostic Tests Referral Diagnostic Testing Nurse Practitioner In-person care Specialty care Care Navigation Urgent care +23

USD 25K+

Urgent Care Nurse Practitioner
Phoenix, AZ

Included Health

Healthcare Collaboration Diagnostic Tests Referral Medical Documentation Diagnostic Testing Nurse Practitioner Cultural Competence In-person care Specialty care +23

USD 25K+

Urgent Care Nurse Practitioner
Washington

Included Health

Health management Diagnostic Tests Referral Diagnostic Testing Nurse Practitioner In-person care Specialty care Care Navigation Urgent care +23

USD 25K+

Urgent Care Nurse Practitioner
North Carolina

Included Health

Diagnostic Tests Referral Medical Documentation Diagnostic Testing Nurse Practitioner In-person care Specialty care Care Navigation Urgent care +21

USD 25K+

Full Time, Registered Nurse - Triage (Care Navigation) - Remote or Hybrid
Remote, United States

Evidence-based recommendations Healthcare navigation Clinical assessments Triage Patient advocacy Therapy HIPAA Compliance Mental Health Support Data integrity +10

USD 90K+

Research RN (Contractor)
San Francisco, Remote

PicnicHealth Remote-first

Motor Functionality Assessment Video Call Tech-savvy Patient Engagement Registered Nurse Active Listening Scheduling GCP Empathy +5

USD 120K+

Senior Quality Improvement Specialist
Remote-SC, United States

Centene Corporation

Member education Healthcare Risk Management Preventive Health Interventions Member Outreach Performance data analysis Provider education Chronic Disease Management Quality improvement Nursing +11

Senior Mid Full Time

USD 67K+

RN - Utilization Management
Work at Home - Florida, United States

Interpreting Criteria Health Plan Experience Clinical Nursing Medical Services Rehabilitation Acute care Consumer Experiences Registered Nurse Utilization management +42

USD 71K+

Patient Education Liaison - REMOTE
Berkeley Heights, United States

Event facilitation Reimbursement Issues Documentation Management Continuing Education Disease Management Patient Education Collaboration Communication

USD 112K+

Remote Clinic Triage Registered Nurse - Primary Care
Washington, USA

Jefferson Healthcare

Phone consultations Interventions Health education Triage Clinical assessment Referrals Utilization management

USD 68K+

Behavioral Health High Acuity Team (BHAT) Specialist - Remote
PA, Working at Home - Pennsylvania

Highmark Health

Psycho-social assessments Lifestyle improvement Health-related decision making Healthcare system navigation Community resource navigation Dialectical behavior therapy Telephonic case management Self-Management Condition Management +24

Senior Full Time

USD 67K+

RN Quality Clinical Management Lead Analyst, Work from Home, Anywhere, USA
Pennsylvania Work at Home

The Cigna Group

Patient Disease Processes Database navigation Ncqa standards Quality of care HEDIS Medical Record Review Quality review Health Services Quality improvement +35

Senior Mid Full Time

USD 73K+

Care Manager (RN)
Remote-CA, United States

Centene Corporation

Personalized care plans Home outreach Resource support Service plans Digital Outreach Service Assessment Foster care Healthcare benefits Telephonic Outreach +15

USD 93K+

Care Manager RN
Work At Home-Colorado

High-Speed Internet Clinical Tools RN license Data Review Telephonic Communication Member engagement Policies and procedures RN licensure Acute care +18

USD 60K+

Quality Review & Audit Lead Analyst - DRG Coder - Remote
Connecticut Work at Home

The Cigna Group

Inpatient coding guidelines HIPAA confidentiality DRG Coding ICD-10 Coding Coding Quality Provider Relations Quality review Coding Guidelines ICD +20

Senior Mid Full Time

USD 65K+

Appeals Nurse
HGB SCA Remote KY

TRICARE policies Tricare DRG ICD-9 Medical Documentation Accreditation Peer review MCG ICD +44

USD 69K+

Clinical HEDIS Manager
United States-%LABEL POSITION TYPE REMOTE WITHIN ONE%

NCQA guidelines Interdisciplinary communication Member Management Submissions Abstraction Data Retrieval Medical Record Review HEDIS Risk Adjustment +23

Senior Mid Full Time

USD 100K+

Care Manager Behavioral Health - Part Time (Weekends) Remote
PA, Working at Home - Pennsylvania

Highmark Health

Health care services Condition Management Health coaching Utilization management Care management RN Health Insurance Nursing Managed Care +15

USD 50K+

Nurse Practitioner - Urgent Care
Remote

Included Health

Management of Health Conditions Diagnostic Tests Referral Diagnostic Testing Nurse Practitioner In-person care Specialty care Triage Care Navigation +27

USD 25K+

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

Ob-gyn Maternity Infertility Women's Health Telephonic case management Integrative functions Clinical resources Clinical Tools Holistic approach +24

USD 54K+

Clinical Program Advisor - Work from Home Anywhere, USA (AAPC or AHIMA Coding Certification Required) LPN or RN Preferred
Alabama Work at Home

The Cigna Group

Reimbursement Policy Claims Data Business writing LPN HCPCS Health Services CPT Business Operations RN +27

USD 92K+

Full Time Registered Nurse, Triage and Navigation
Remote

Evidence-based recommendations Healthcare navigation Mental Health Support Clinical assessments Triage Therapy Data integrity HIPAA Compliance Advocacy +9

USD 86K+

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