Top 377 Registered nurse manager Jobs in Remote *

Claims - Care Manager, RN, Claims
Wellcove —Remote
- Full-time
- Remote
- RN License
- Mid-level
- Geriatrics
Quick Apply
Denials & Appeals Administrator (RN)
Boston Medical Center —Remote
- $43.03 - $62.50 an hour
- Full-time
- Remote
- Nursing
- RN License
- 5 years
- Health insurance
- Dental insurance
RN - Registered Nurse - Clinical Documentation Improvement Educator
Geisinger —Remote
- Full-time
- Remote
- Nursing
- RN License
- Mid-level
- Tuition reimbursement
- Parental leave
Clinical Documentation Specialist
City of Hope —Remote
- $45.20 - $63.29 an hour
- Full-time
- Nursing
- RN License
- Mid-level
Registered Nurse Supervisor - Alerts
Cadence Health —Remote
- $80,000 - $100,000 a year
- Call employer
- Remote
- RN License
- Urgent Care
- Mid-level
- Paid parental leave
- Health insurance
Clinical Documentation Specialist (CDI)
Solventum —Remote
- $96,000 - $132,000 a year
- Full-time
- Nursing
- Microsoft Excel
- RN License
- Health savings account
- Disability insurance
4d
Nurse Care Manager
Evergreen Nephrology —Remote
- $90,000 - $103,000 a year
- Remote
- Nursing
- Microsoft Outlook
- RN License
- Paid parental leave
- Health savings account
Quick Apply
Clinical Appeals & CDI Manager
Managed Resources, Inc (MRI) —Remote
- $95,000 - $142,000 a year
- Full-time
- Remote
- Nursing
- RN License
- Writing skills
- Paid holidays
- Health insurance
Manager of Clinical Annotation - Remote
UnitedHealthcare —Atlanta, GA
- $91,700 - $163,700 a year
- Full-time
- Remote
- Nursing
- RN License
- 5 years
Utilization Review RN - Full-time - REMOTE
Providence —Irvine, CA
- $57.28 - $88.92 an hour
- 8 hour shift
- Remote
- Nursing
- RN License
- Mid-level
- Paid parental leave
- Paid holidays
2d
National Director, Care Educators
Apellis Pharmaceuticals —Remote
- $190,000 - $285,000 a year
- Full-time
- Nursing
- Up to 50% travel
- RN License
- Disability insurance
- Family leave
Sentara Health Plans is hiring for a Manager, Quality Performance and Outreach (CAHPS/ HOS/ Medicare)- Remote
Sentara Health Administration, Inc. —Norfolk, VA
- $38.22 - $63.70 an hour
- Overtime
- Remote
- Nursing
- RN License
- Mid-level
- 403(b) matching
- Paid parental leave
Quick Apply
3d
Clinical Case Manager, RN / Nurse Ambassador
United Biosource Corporation —Remote
- Overtime
- Remote
- Nursing
- RN License
- Research
- Wellness program
- Health savings account
Telephonic Nurse Ambassador
United Biosource Corporation —Remote
- Overtime
- Remote
- Nursing
- RN License
- Research
- Wellness program
- Health savings account
Registered Nurse – Virtual Care & Care Management (Remote)
CareTalk Health —Remote
- $35 an hour
- Full-time
- Remote
- Nursing
- RN License
- Computer literacy
Quick Apply
Case Manager / RN
MedWatch —Remote
- $72,000 - $81,000 a year
- Full-time
- Remote
- Nursing
- RN License
- Residential
Registered Nurse – Care Management (Remote) (Evening & Overnight Schedule)
CareTalk Health —Remote
- $35 an hour
- Overnight shift
- Remote
- Nursing
- RN License
- Computer literacy
Quick Apply
Registered Nurse (Remote) (0600-1800 EST)
Florida Telehealth Medical Group (FTMG) —Remote
- $36 an hour
- Full-time
- Remote
- Google Workspace
- Nursing
- RN License
- Health insurance
- Dental insurance
Quick Apply
CDI Specialist - Health Information
Rady Children's Health —Remote
- $39.51 - $54.33 an hour
- Anatomy knowledge
- LVN
- RN License
Manager, Inpatient
Point32Health —Remote
- $101,216.82 - $151,825.24 a year
- Weekends as needed
- Nursing
- RN License
- Customer service
- Disability insurance
- Health insurance
9d

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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

registered nurse manager jobs in remote *

Claims - Care Manager, RN, Claims

Denials & Appeals Administrator (RN)

RN - Registered Nurse - Clinical Documentation Improvement Educator

Clinical Documentation Specialist

Registered Nurse Supervisor - Alerts

Clinical Documentation Specialist (CDI)

Nurse Care Manager

Clinical Appeals & CDI Manager

Manager of Clinical Annotation - Remote

Utilization Review RN - Full-time - REMOTE

National Director, Care Educators

Sentara Health Plans is hiring for a Manager, Quality Performance and Outreach (CAHPS/ HOS/ Medicare)- Remote

Clinical Case Manager, RN / Nurse Ambassador

Telephonic Nurse Ambassador

Registered Nurse – Virtual Care & Care Management (Remote)

Case Manager / RN

Registered Nurse – Care Management (Remote) (Evening & Overnight Schedule)

Registered Nurse (Remote) (0600-1800 EST)

CDI Specialist - Health Information

Manager, Inpatient

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