Top 41311 Rn Nurse Manager Jobs

Claims - Care Manager, RN, Claims
Wellcove —Remote
- Full-time
- Remote
- RN License
- Mid-level
- Geriatrics
Quick Apply
Clinical Case Manager, RN / Nurse Ambassador
United Biosource Corporation —Remote
- Overtime
- Remote
- Nursing
- RN License
- Research
- Wellness program
- Health savings account
Telehealth Triage Registered Nurse (RN)
Lumina Care —Remote
- $38 - $45 an hour
- Weekends as needed
- Remote
- Nursing
- Psychiatry
- RN License
- Paid holidays
- Health insurance
Quick Apply
Remote! Bilingual (Spanish/English) Registered Nurse (RN) Case Manager
Valeris —Remote
- Remote
- Background check
- Spanish
- RN License
- Health savings account
- AD&D insurance
Quick Apply
Remote Behavioral Registered Nurse (RN)– Remote Care Manager
CareGenix Solutions LLC —Remote
- Part-time
- Remote
- Nursing
- RN License
- HIPAA
Quick Apply
14d
Registered Nurse (RN) – Part Time Remote Care Manager
CareGenix Solutions LLC —Remote
- $19 - $24 an hour
- Part-time
- Remote
- Spanish
- Nursing
- RN License
Quick Apply
RN, Cancer Screening & Prevention
Color —Remote
- $110,000 - $120,000 a year
- Remote
- Spanish
- Nursing
- RN License
Case Manager / RN
MedWatch —Remote
- $72,000 - $81,000 a year
- Full-time
- Remote
- Nursing
- RN License
- Residential
Registered Nurse – Virtual Care & Care Management (Remote)
CareTalk Health —Remote
- $35 an hour
- Full-time
- Remote
- Nursing
- RN License
- Computer literacy
Quick Apply
Registered Nurse Care Manager (RNCM)
Heritage Health Network —Remote
- $45 - $50 an hour
- Remote
- Nursing
- RN License
- Mid-level
Quick Apply
4d
Registered Nurse (Remote) (0600-1800 EST)
RX.ME —Remote
- $36 an hour
- Full-time
- Remote
- Google Workspace
- Nursing
- RN License
- Health insurance
- Dental insurance
Quick Apply
4d
RN Telehealth
Total Life, Inc. —Florida
- Full-time
- Remote
- Spanish
- Nursing
- Psychiatry
Quick Apply
Virtual Nurse Case Manager/Neurology (12-9p EST)
Momentum Life Sciences —Remote
- $38 - $40 an hour
- Full-time
- Remote
- Nursing
- RN License
- English
Triage Nurse - RN (Night Shift)
SCP Health —Remote
- $27 - $40 an hour
- Full-time
- Remote
- Nursing
- RN License
- HIPAA
- Paid holidays
- Health insurance
4d
RN Case Manager
Zócalo Health —Remote
- $85,000 a year
- Full-time
- Remote
- RN License
- Writing skills
- Mid-level
- Health insurance
- Dental insurance
Case Manager Registered Nurse
CVS Health —Ohio
- $60,522 - $129,615 a year
- 8 hour shift
- Remote
- Nursing
- Microsoft Excel
- RN License
- Health insurance
- Dental insurance
1d
Clinical Nurse Manager - Maternal Newborn - Children's Hospital
University of Missouri Health Care —Columbia, MO
- $108,971 - $177,590 a year
- Full-time
- Nursing
- RN License
- Bachelor of Science
- Paid holidays
- Health insurance
Hospice RN - Case Manager
Care Initiatives Hospice - Sioux City —Pocahontas, IA
- Full-time
- CPR Certification
- RN License
- Hospital
- Paid training
- Health insurance
Quick Apply
Clinic Manager RN - St. Joseph KidsCare Pediatric
Swope Health —Saint Joseph, MO
- $85,000 a year
- Nursing
- RN License
- Mid-level
- Health savings account
- AD&D insurance
Quick Apply
Registered Nurse Case Manager (RN) $5,000 Sign On Bonus
St. Croix Hospice —Dubuque, IA
- Full-time
- Nursing
- RN License
- Mid-level
- Paid holidays
- Disability insurance
Quick Apply
8d

I want to receive the latest job alert for Rn Nurse Manager

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Claims - Care Manager, RN, Claims

Wellcove
Remote

Quick Apply

Job Details

Full-time

Qualifications

RN License

Full Job Description

Who We Are
Wellcove has been recognized as the nation’s leading full-service senior market solutions provider for over 25 years. Our solutions span the insurance senior market sector, focusing on long-term care and Medicare Supplement plans. However, we don’t stop there. Wellcove also addresses challenges faced in accident & health, disability, and supplemental health insurance programs.

Our team provides individuals and their families with peace of mind knowing their insurance needs will be met in a thoughtful, efficient manner. We are able to do this because of our dedicated associates, innovative solutions, and state-of-the-art technology.

We are seeking an experienced Registered Nurse (RN) to serve as a Care Manager supporting Long Term Care (LTC) insurance claims. This individual contributor role is responsible for conducting comprehensive clinical eligibility reviews to determine whether policyholders meet the benefit eligibility requirements outlined in their LTC policy.
The Care Manager, RN will complete and document Chronically Ill Certifications (CICs) and develop Plans of Care (POCs) for initial claims and ongoing recertifications, ensuring determinations are clinically sound, and policy aligned.

Key Responsibilities

Perform detailed clinical reviews of LTC claim files to determine eligibility in accordance with policy provisions and regulatory requirements.
Assess Activities of Daily Living (ADLs), cognitive impairment, diagnoses, comorbidities, and level of care needs.
Review medical records, Minimum Data Set (MDS) assessments, facility documentation, home health records, daily visit notes, and supporting claim forms.
Determine whether the insured meets the policy definition of Chronically Ill.
Prepare and document Chronically Ill Certifications (CICs) and individualized Plans of Care (POCs) for initial approvals and recertifications.
Clearly document clinical rationale to support benefit determinations.
Collaborate with Claims, Eligibility, and Customer Service teams to obtain additional documentation when necessary.
Maintain knowledge of LTC policy language, benefit triggers, and regulatory requirements.

Qualifications

Active, unrestricted Registered Nurse (RN) license required.
Clinical experience in long-term care, home health, geriatrics, case management, or utilization review preferred.
Experience reviewing medical records and assessing functional and cognitive impairment.
Knowledge of LTC insurance benefit triggers, ADL requirements, and chronically ill certification standards preferred.
Strong clinical judgment, critical thinking, and documentation skills.
Ability to manage multiple cases and meet turnaround expectations.

At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.

Quick Apply

Refine Your Search

Rn Nurse Manager jobs

Claims - Care Manager, RN, Claims

Clinical Case Manager, RN / Nurse Ambassador

Telehealth Triage Registered Nurse (RN)

Remote! Bilingual (Spanish/English) Registered Nurse (RN) Case Manager

Remote Behavioral Registered Nurse (RN)– Remote Care Manager

Registered Nurse (RN) – Part Time Remote Care Manager

RN, Cancer Screening & Prevention

Case Manager / RN

Registered Nurse – Virtual Care & Care Management (Remote)

Registered Nurse Care Manager (RNCM)

Registered Nurse (Remote) (0600-1800 EST)

RN Telehealth

Virtual Nurse Case Manager/Neurology (12-9p EST)

Triage Nurse - RN (Night Shift)

RN Case Manager

Case Manager Registered Nurse

Clinical Nurse Manager - Maternal Newborn - Children's Hospital

Hospice RN - Case Manager

Clinic Manager RN - St. Joseph KidsCare Pediatric

Registered Nurse Case Manager (RN) $5,000 Sign On Bonus

I want to receive the latest job alert for Rn Nurse Manager

Related Searches

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected