Top 59 Senior nurse Jobs in Remote

Claims - Care Manager, RN, Claims
Wellcove —Remote
- Full-time
- Remote
- RN License
- Mid-level
- Geriatrics
Quick Apply
Nursing Informatics Specialist / Functional Analyst
Ben Allegretti Consulting (BAC) —Remote
- $105,000 - $140,000 a year
- Full-time
- Remote
- Nursing
- RN License
- Master's degree
- Health insurance
- Dental insurance
Quick Apply
2d
Care Manager, LPN (Central Time Zone)
Curana Health —Remote
- Full-time
- Nursing
- Mid-level
- Travel
3d
Division Director of Resident Care
Discovery Senior Living —Remote
- $140,000 a year
- Nursing
- RN License
- 5 years
Quick Apply
RN - School Nurse - PRN
Avel eCare —Remote
- 8 hour shift
- Nursing
- Management
- Medication administration
1d
Care Manager, LPN (Eastern Time Zone)
Curana Health —Remote
- Full-time
- Nursing
- Mid-level
- Travel
3d
Senior Manager, Agios Clinical Educator (Mid-South)
Agios Pharmaceuticals —Remote
- $131,035 - $196,553 a year
- Nursing
- Up to 50% travel
- 5 years
- Health insurance
Sr. Medical Education Specialist (Neuro)
Penumbra —Remote
- $100,000 - $150,000 a year
- Weekends as needed
- Remote
- Office
- Ability to lift 50 pounds
- Bachelor's degree
- Paid parental leave
- AD&D insurance
Senior Care Specialist (Registered Nurse) – Work From Home
Sagility —Remote
- From $37 an hour
- Seasonal
- Remote
- Nursing
- Microsoft Excel
- Microsoft Outlook
- Work from home
20h
Regional Director of Resident Care (Registered Nurse/RN)
Discovery Senior Living - LakeHouse —Remote
- $120,000 - $135,000 a year
- Weekends as needed
- Background check
- Nursing
- RN License
- Paid training
- Paid holidays
Quick Apply
LPN /Health Care Coordinator (full-time 2nd shift)
Discovery Village Des Plaines —Remote
- $33 - $36 an hour
- Part-time
- Remote
- Background check
- RN License
- Mid-level
- Paid training
- Paid holidays
Quick Apply
2d
Care Manager - LVN
SCAN Health Plan —Lakewood, CA
- $34.47 - $55.14 an hour
- Full-time
- Remote
- Background check
- LVN
- Mid-level
- Wellness program
- Paid holidays
Quick Apply
CARE MANAGER - NURSING
CenterLight Health System —Remote
- $98,000 - $108,000 a year
- Full-time
- Remote
- Bilingual
- Nursing
- OSHA
11d
Senior Clinical Quality Performance Specialist
Amerihealth Caritas —Manchester, NH
- Full-time
- Remote
- Nursing
- RN License
- 5 years
Sr Review Coordinator
Integrated Management Strategies —Remote
- Email
- Remote
- RN License
- Mid-level
- 3 years
Quick Apply
2d
Clinical Care Coordinator I
One Call —Remote
- $19.04 - $28.56 an hour
- Full-time
- Nursing
- Microsoft Outlook
- Medical office experience
- Disability insurance
- Health insurance
RN, Care Management (SCAN Temp)
SCAN Health Plan —Los Angeles, CA
- $50 - $55 an hour
- Full-time
- Remote
- Background check
- Spanish
- Nursing
- Health insurance
- Paid sick time
Quick Apply
10d
Senior Clinical Reimbursement Specialist
Veracyte —San Diego, CA
- $86,098 - $137,657 a year
- Email
- Remote
- Nursing
- RN License
- Analysis skills
Quick Apply
Med Mgmt Clinician Sr (contract)
Elevance Health —Remote
- 8 hour shift
- Remote
- 6 years
- LVN
- RN License
9d
Team Lead Senior Auditor CCV (Place of Service, Short-Stay, Readmission)
Cotiviti —Remote
- $112,000 - $132,000 a year
- Full-time
- Nursing
- RN License
- Customer service
- Paid holidays
- Disability insurance

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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

Nursing Informatics Specialist / Functional Analyst

Care Manager, LPN (Central Time Zone)

Division Director of Resident Care

RN - School Nurse - PRN

Care Manager, LPN (Eastern Time Zone)

Senior Manager, Agios Clinical Educator (Mid-South)

Sr. Medical Education Specialist (Neuro)

Senior Care Specialist (Registered Nurse) – Work From Home

Regional Director of Resident Care (Registered Nurse/RN)

LPN /Health Care Coordinator (full-time 2nd shift)

Care Manager - LVN

CARE MANAGER - NURSING

Senior Clinical Quality Performance Specialist

Sr Review Coordinator

Clinical Care Coordinator I

RN, Care Management (SCAN Temp)

Senior Clinical Reimbursement Specialist

Med Mgmt Clinician Sr (contract)

Team Lead Senior Auditor CCV (Place of Service, Short-Stay, Readmission)

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