Top 80 senior nurse Jobs in remote

Claims - Care Manager, RN, Claims
Wellcove —Remote
- Full-time
- Remote
- RN License
- Mid-level
- Geriatrics
Quick Apply
Care Manager, Telephonic Nurse-Part Time Evenings & Weekends
Centerwell —Remote
- $71,100 - $97,800 a year
- Part-time
- Remote
- CPR Certification
- Nursing
- RN License
- Paid parental leave
- Paid holidays
2d
Care Manager, LPN - Eastern Time Zone
Curana Health —Remote
- Full-time
- Nursing
- Mid-level
- Travel
6h
Utilization Review Nurse-LVN/LPN
Personify Health —Remote
- $25 - $30 an hour
- Weekends as needed
- Microsoft Outlook
- LVN
- Mid-level
- Health insurance
- Dental insurance
15h
Remote LPN Care Coordinator - Spanish Speaking
Comprehensive Rehab Consultants —Remote
- $28 - $32 an hour
- Full-time
- Remote
- Spanish
- Nursing
- LVN
- Disability insurance
- Health insurance
Quick Apply
Regional Director of Resident Care
Arvum Senior Living —Remote
- $115,000 a year
- Nursing
- RN License
- Computer literacy
- Paid holidays
- Health insurance
Quick Apply
Remote LPN Care Coordinator - Korean Speaking
Comprehensive Rehab Consultants —Remote
- $28 - $32 an hour
- Full-time
- Remote
- Nursing
- LVN
- RN License
- Disability insurance
- Health insurance
Quick Apply
Regional Director of Resident Care
Discovery Senior Living - Arvum —Remote
- $115,000 a year
- Nursing
- RN License
- Computer literacy
- Paid holidays
- Health insurance
Quick Apply
Regional Director of Resident Care - RN License
Discovery Senior Living - LakeHouse —Remote
- $110,000 - $120,000 a year
- Remote
- Nursing
- RN License
- 5 years
- Paid holidays
- Health insurance
Quick Apply
Case Management Senior Analyst - Allegiance - Work at Home
The Cigna Group —Remote
- $57,600 - $96,000 a year
- Online Application
- Remote
- Nursing
- RN License
- Computer literacy
- Paid holidays
- Health insurance
2d
Medical Management Specialist, LVN
SCAN Health Plan —Lakewood, CA
- $30.77 - $44.52 an hour
- Full-time
- Remote
- Background check
- Nursing
- Microsoft Excel
- Wellness program
- Paid holidays
Quick Apply
3d
High Risk Care Coordinator
Oasis Health Partners —Chicago, IL
- $33.65 - $48.08 an hour
- Remote
- Nursing
- Mid-level
- US work authorization
- Health insurance
- Dental insurance
Quick Apply
Divisional Vice President of Resident Care (RN/DON)
Discovery Senior Living - DMG —Remote
- $180,000 - $200,000 a year
- Full-time
- Background check
- Nursing
- RN License
- Paid training
- Paid holidays
Quick Apply
2d
Senior Nurse- Safeguarding and Mental Health
Keys Group —Remote
- $45,000 - $50,000 a year
- RN License
- Research
- Residential
- Employee assistance program
Quick Apply
Care Review Clinician (BH Licensed) - Remote in FL
Molina Healthcare —Miami, FL
- $26.41 - $51.49 an hour
- Full-time
- Remote
- LMFT
- Licensed Clinical Social Worker
- Mid-level
- Health insurance
Sr Clinical Data Abstractor
Natera —Remote
- Remote
- Nursing
- HIPAA
- Continuous improvement
- Commuter assistance
- Disability insurance
Senior Advisor, Clinical Product and Clinical AI Enablement
The Cigna Group —Remote
- $116,100 - $193,500 a year
- Online Application
- Remote
- Nursing
- 6 years
- RN License
- Paid holidays
- Health insurance
7d
Senior Clinical Enablement Lead
Eko Health —Remote
- $108,000 - $151,500 a year
- Full-time
- Nursing
- Up to 50% travel
- Bachelor of Science
- Disability insurance
- Health insurance
Remote Registered Nurse (RN)
Pine Park Health —Reno, NV
- Remote
- Nursing
- RN License
- HIPAA
- Paid holidays
- Health insurance
Quick Apply
PRN Remote MDS Coordinator Minnesota
Eden Senior Care —Rochester, MN
- $36 - $43 an hour
- Part-time
- Remote
- RN License
- Mid-level
- Communication skills
Quick Apply

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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

senior nurse jobs in remote

Claims - Care Manager, RN, Claims

Care Manager, Telephonic Nurse-Part Time Evenings & Weekends

Care Manager, LPN - Eastern Time Zone

Utilization Review Nurse-LVN/LPN

Remote LPN Care Coordinator - Spanish Speaking

Regional Director of Resident Care

Remote LPN Care Coordinator - Korean Speaking

Regional Director of Resident Care

Regional Director of Resident Care - RN License

Case Management Senior Analyst - Allegiance - Work at Home

Medical Management Specialist, LVN

High Risk Care Coordinator

Divisional Vice President of Resident Care (RN/DON)

Senior Nurse- Safeguarding and Mental Health

Care Review Clinician (BH Licensed) - Remote in FL

Sr Clinical Data Abstractor

Senior Advisor, Clinical Product and Clinical AI Enablement

Senior Clinical Enablement Lead

Remote Registered Nurse (RN)

PRN Remote MDS Coordinator Minnesota

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