Top 1786 Remote work from home Jobs in Wake Forest, Nc

Physical Health Registered Nurse (Remote)
Vaya Health —North Carolina
- $68,033.34 - $88,443.35 a year
- Weekends as needed
- Remote
- Nursing
- RN License
- Computer literacy
Outbound Call Specialist
Open Desk —Wake Forest, NC
- $17 an hour
- Full-time
- Remote
- Research
- Organizational skills
- Communication skills
- Paid training
- Paid holidays
Quick Apply
2d
CUSTOMER SERVICE ASSOCIATE
GRADE POTENTIAL, LLC —Raleigh, NC
- $35,000 - $55,000 a year
- Overtime
- Remote
- 11+ years
- Financial services
- Entry level
- Paid holidays
- Health insurance
Remote Energy Efficiency Customer Support Specialist
CLEAResult Consulting Inc. —Raleigh, NC
- $17 an hour
- Full-time
- Remote
- Sales
- High school diploma or GED
- US work authorization
- Health insurance
- Dental insurance
Quick Apply
3d
Customer Support Representative
Five Star Call Centers —Raleigh, NC
- $14 an hour
- Full-time
- Remote
- Organizational skills
- Computer skills
- 1 year
- Paid training
2d
Customer Solutions Specialist (Second Shift)
AWeber —Raleigh, NC
- Weekends as needed
- Remote
- Mid-level
- Paid holidays
- Disability insurance
Patient Finance Representative - Oncology
WakeMed Health & Hospitals —Raleigh, NC
- Full-time
- Remote
- High school diploma or GED
- Business
- Associate's degree
8d
Seasonal (Temporary) Customer Service Call Center Agent
TRANZACT —Raleigh, NC
- $15.50 an hour
- 8 hour shift
- Remote
- English
- High school diploma or GED
- Older adults
Quick Apply
2d
Billing Specialist - Patient Accounts
Kind Behavioral Health —Raleigh, NC
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Customer service
Quick Apply
Supervisor, Claims & Billing
WakeMed Health & Hospitals —Raleigh, NC
- Full-time
- Remote
- Management
- Mid-level
- Accounting
Remote Processing Specialist
CLEAResult Consulting Inc. —Raleigh, NC
- $16 an hour
- Full-time
- Remote
- US work authorization
- Organizational skills
- Entry level
- Health insurance
- Dental insurance
Quick Apply
3d
Remote Customer Service Representative
Afni, Inc. —Raleigh, NC
- $14.50 - $15.00 an hour
- 8 hour shift
- Remote
- Background check
- 18 years or older
- High school diploma or GED
- Paid training
- Health insurance
Quick Apply
MEDICAL RECORDS CODER II (Outpatient)
Duke Health —Durham, NC
- Full-time
- Remote
- Anatomy knowledge
- Management
- No experience needed
Remote Customer Service Representative
ACC PREMIERE —Raleigh, NC
- $11.50 - $12.00 an hour
- Full-time
- Remote
- High school diploma or GED
- Data entry
- 2 years
- Paid training
Quick Apply
1d
Junior Database Administrator - Entry Level - REMOTE
Fortified Data —Raleigh, NC
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Computer Science
Quick Apply
Payroll Coordinator II - REMOTE
Ryder System —Raleigh, NC
- $25 - $29 an hour
- Remote
- Spanish
- Mid-level
- 3 years
- Disability insurance
- Health insurance
5d
Graphic Designer
PENDIUM Publishing House —Raleigh, NC
- Email
- Remote
- Mid-level
- Organizational skills
- Communication skills
- Work from home
Customer Service Representative I (Remote Raleigh, NC)
First Citizens Bank —Raleigh, NC
- Full-time
- Remote
- Spanish
- High school diploma or GED
- Bachelor's degree
17h
Seasonal Customer Service Representative - 2026 (Mid-Atlantic & Midwest)
Minted —Raleigh, NC
- $17.62 - $19.19 an hour
- Weekends as needed
- Remote
- Residential
- Bachelor's degree
- Experience equivalent to degree accepted
Quick Apply
8d
Certified Coder - Remote
Granville Health System —Oxford, NC
- Part-time
- Remote
- Computer literacy
- Computer skills
- Senior level
Quick Apply

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Physical Health Registered Nurse (Remote)

Vaya Health -
North Carolina

Apply Now

Job Details

Full-time
$68,033.34 - $88,443.35 a year

Qualifications

Computer operation
Nursing
Managed care organization experience
Computer literacy
Coaching
Patient management software
Acute care facility experience
EMR/EHR
Utilization management
Conflict management
Mentoring
Resource utilization in healthcare
Productivity software
Benchmarking
Associate's degree
Associate Degree in Nursing
Healthcare data reporting
Nursing

Full Job Description

LOCATION: Remote – this a home based, virtual position that operates Monday – Friday from 8:30am-5:00pm EST. Vaya Health welcomes applications from NC, SC, GA, TN, VA, MD, and FL.

GENERAL STATEMENT OF JOB

The Physical Health Registered Nurse is responsible for completing clinical reviews for appropriateness, medical necessity, and quality. The Physical Health Registered Nurse applies standardized clinical review criteria to determine medical necessity for service authorization requests. The Physical Health Registered Nurse refers service authorization requests to an appropriate physician peer reviewer when medical necessity criteria are not clearly met. Reviews performed by the individual in this position may be pre-service, concurrent, or retrospective in nature. This position is part of a team of nurses, physicians, psychologists, pharmacists and non-clinical associates who work closely to care for our members.

The day-to-day operations of the Physical Health Utilization Management Department require coverage on weekends and holidays. The incumbent in this position will be required to participate in a rotation to ensure coverage every day including weekends and holidays. The amount of work on scheduled weekends and holidays will be subject to change.

ESSENTIAL JOB FUNCTIONS

Process requests for authorization of services:

Responsible for reviewing requests for authorization of services including inpatient hospital admissions, re-admissions, inpatient rehabilitation services, skilled nursing admissions, home care /home infusion services, outpatient and/or inpatient services as designated.
Documents timely decisions and actions taken within the managed care information system (MCIS).
Meets contractual timelines for completion of review activities
Communicates and interacts with providers as well as internal and external partners to facilitate and coordinate the activities of the UM process.
Utilizes technology (computer-based systems) and resources to support work activities appropriately.
Communicates determinations to providers per established business process

Supporting UM Functions:

Actively participates in all required staff meetings and complex case rounds
Perform discharge planning to achieve safe and timely enrollee discharges from hospitals and facilities
Successfully completes Inter-rater Reliability (IRR) training, exams, and testing with at least an 80% passing rate or above thresholds established by management
Follows all UM workflow processes

All other duties as assigned in support of UM functions.

KNOWLEDGE, SKILLS, & ABILITIES

This position requires a high degree of autonomy, professional relationships and organizational skills. Applicants with thorough knowledge of the following are prioritized:

Primary care, behavioral health and healthcare system in NC;
Vaya Health Provider Network;
Medical practice workflows;
Vaya contracts with the NC Department of Heath and Human Services (NCDHHS) and other contracts for which Vaya is responsible;
Vaya organizational purpose/role per federal and state statute, strategic plan, leadership and departmental roles, relationships and scope;
Federal and state confidentiality requirements;
Member and staff health & safety requirements;
Corporate compliance requirements;
Vaya Policies and Procedures;
Project management principles.

Additional required skills and abilities include but are not limited to the following:

Clear, concise and appropriate verbal, written and electronic communication;
Ability to present in large group settings;
Ability to adapt to rapid changes;
Effectively implement new initiatives;
Computer literacy and familiarity with Microsoft Office software as well as Vaya's Administrative Health Record and/or Care Management Platform, Vaya’s Member Services and UM Platform.
Strong conceptual skills, with knowledge and skill in problem-solving, decision-making, conflict resolutions, and critical thinking.
Ability to mentor, coach and facilitate change and innovation.
Ability to develop reporting mechanisms that will produce data needed to support and benchmark quality initiatives.

PHYSICAL REQUIREMENTS

Close visual acuity to perform activities such as preparation and analysis of documents; viewing a computer terminal; and extensive reading.
Physical activity in this position includes crouching, reaching, walking, talking, hearing and repetitive motion of hands, wrists and fingers.
Sedentary work with lifting requirements up to 10 pounds, sitting for extended periods of time.
Mental concentration is required in all aspects of work.

EDUCATION & EXPERIENCE REQUIREMENTS

Associate Degree in Nursing required. Bachelor’s Degree in Nursing preferred.

Five (5) years of clinical experience preferably across the continuum of care with at least two years of acute care experience.
Experience performing utilization management functions in a managed care setting.
Proficient at using software programs such as Microsoft Office tools.

Licensure/Certification Required:

Active and unrestricted RN License in the State of North Carolina or Nurse Licensure Compact (NLC) license.

RESIDENCY REQUIREMENTS: The person in this position must live in NC, SC, GA, TN, VA, MD, or FL.

SALARY: Depending on qualifications & experience of candidate. This position is exempt and is not eligible for overtime compensation.

DEADLINE FOR APPLICATION: Open Until Filled

APPLY: Vaya Health accepts online applications in our Career Center, please visit https://www.vayahealth.com/about/careers/.

Vaya Health is an equal opportunity employer.

Apply Now

Refine Your Search

remote work from home jobs in wake forest, nc

Physical Health Registered Nurse (Remote)

Outbound Call Specialist

CUSTOMER SERVICE ASSOCIATE

Remote Energy Efficiency Customer Support Specialist

Customer Support Representative

Customer Solutions Specialist (Second Shift)

Patient Finance Representative - Oncology

Seasonal (Temporary) Customer Service Call Center Agent

Billing Specialist - Patient Accounts

Supervisor, Claims & Billing

Remote Processing Specialist

Remote Customer Service Representative

MEDICAL RECORDS CODER II (Outpatient)

Remote Customer Service Representative

Junior Database Administrator - Entry Level - REMOTE

Payroll Coordinator II - REMOTE

Graphic Designer

Customer Service Representative I (Remote Raleigh, NC)

Seasonal Customer Service Representative - 2026 (Mid-Atlantic & Midwest)

Certified Coder - Remote

I want to receive the latest job alert for remote work from home in wake forest, nc

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