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Featured Companies are employers who have come directly to FlexJobs, been approved by our staff, and have directly posted their jobs to the FlexJobs site.
- Full-Time
- Employee
- Portland, OR
Evaluates patients' health status, provides patient education, performs interventions based on care requirements, and ensures a safe and therapeutic environment. Implements protocols for reporting adverse reactions, administers vaccines, and maintain..
- 100% Remote Work
- Full-Time
- Temporary
- US National
Answering inbound phone calls, processing cases, loading authorizations, and making follow-up phone calls. Maintaining complete and accurate documentation. Reviewing and following prior authorization procedures. Providing nurse support and training t..
- Hybrid Remote Work
- Full-Time
- Employee
- 35.00 - 35.00 USD Hourly
- Grafton, NH
Conduct thorough clinical assessments of patients, collaborate with office staff, engage with healthcare professionals and stakeholders, and ensure compliance with contractual obligations and regulatory standards.
- Hybrid Remote Work
- Full-Time
- Temporary
- Columbus, NE
Ensures accurate screenings, evaluations, and determinations through clinical assessment. Determines appropriate level of care and service needs. Utilizes computer proficiency and effective communication skills to conduct work and interact with healt..
- Hybrid Remote Work
- Alternative Schedule
- Employee
- 28.03 - 54.95 USD Hourly
- Farmington, CT
Provide patient care through telephone calls with varying levels of acuity and medical concerns. Collect and document patient information, prioritize activities, implement care plans, and provide age-appropriate and population-specific care. Must be ..
- 100% Remote Work
- Full-Time
- Employee
- Glendale, AZ
Provide exceptional home health care, including medication administration, wound care, treatments, client assessments, patient education, and accurate documentation. Requires graduation from an accredited nursing program and current nursing license.
- 100% Remote Work
- Alternative Schedule
- Employee
- 70,200 - 137,800 USD Annually
- Denver, CO
Effectively manages resources, develops strategic partnerships, collects data, and ensures compliance with regulatory standards as a subject matter expert in clinical compliance.
- 100% Remote Work
- Full-Time
- Employee
- 58,300 - 114,300 USD Annually
- US National
Makes outbound calls to assess members' current health status, case manages members in the pre-operative and post-operative phases, identifies gaps or barriers in treatment plans, provides patient education to assist with self-management.
- 100% Remote Work
- Full-Time
- Employee
- 60,000 - 85,000 USD Annually
- Atlanta, GA
Independently review cases for accurate ICD-10-CM risk-adjusted coding and clinical documentation. Stay updated on changes in the Risk Adjustment field and maintain high proficiency through continuing education. Must have minimum of 3 years of clinical...
- 100% Remote Work
- Full-Time
- Employee
- NC
Review Musculoskeletal care requests for medical necessity, assess customer needs, determine medical appropriateness, and maintain contact with parties involved. Must have an active RN license in NC and proficiency in computer applications. Prior aut..
- Hybrid Remote Work
- Full-Time
- Employee
- Worcester, MA
Provides comprehensive case management and care coordination for a diverse panel of patients. "Coaches" patients to improve their health behavior and educates them on medication protocols. Works closely with clinical pharmacist to manage disease and ..
- Hybrid Remote Work
- Full-Time
- Employee
- San Antonio, TX
Conduct audits to ensure compliance with CMS, NCQA, and Health Plan guidelines. Prepare reports on departmental functions and trends. Participate in the development and execution of auditing processes. Manage and perform tasks related to annual audit..
- 100% Remote Work
- Full-Time
- Employee
- 58,300 - 114,300 USD Annually
- MI, IN, KY, TN, GA, FL, OH, NC, SC, WV, VA, PA, DC, CT, NJ, NY, RI, NH, ME, MD, DE, VT, MA, ND, SD, NE, KS, OK, TX, MN, IA, MO, AR, LA, WI, IL, MS, AL
Assess and interpret member needs, collaborate with medical directors, and facilitate effective discharge planning. Apply clinical expertise, identify delays in care, and maintain compliance with federal and state regulations.
- 100% Remote Work
- Full-Time
- Employee
- MA
Perform pre-service/prior authorization clinical coverage review of Home Health Services and Day Habilitation. Review and interpret clinical/medical records from providers. Answer provider inquiries/encounters. Determine appropriateness of community ..
- 100% Remote Work
- Full-Time
- Employee
- 58,300 - 114,300 USD Annually
- US National
Perform initial and concurrent review of inpatient cases applying evidenced-based criteria (InterQual criteria) .Discuss cases with facility healthcare professionals to obtain plans-of-care
- 100% Remote Work
- Full-Time/Part-Time
- Employee
- Joplin, MO
Provide hospice nursing care, administer medication, wound care, treatments, and procedures, perform client assessments, and report changes to Clinical or Client Services Manager. Full-time position with flexible schedules, clinical support, and...
- 100% Remote Work
- Full-Time
- Employee
- 58,300 - 114,300 USD Annually
- US National
Perform telephonic outreach to members, gather clinical information, assist with urgent needs, provide patient education, and attend team meetings. Bilingual Spanish/English RN with 3+ years of clinical experience required.
- Hybrid Remote Work
- Full-Time
- Temporary
- 46.50 - 53.00 USD Hourly
- CA
Timely completion of prior authorization requests using evidence-based standards. Requires knowledge of Milliman Care Guidelines, Medi-Cal policies, utilization management, case management, critical thinking skills, Bachelor's degree in Nursing, and..
- 100% Remote Work
- Full-Time
- Employee
- 28.03 - 54.95 USD Hourly
- NJ
Perform pre-service clinical coverage review, interpret state and federal mandates, communicate benefit determinations, and make decisions that impact members. Must have an RN license in New Jersey and experience in utilization review.
- 100% Remote Work
- Full-Time
- Employee
- 33.75 - 66.25 USD Hourly
- US National
Assist managers and supervisors with escalated issues. Develop training materials and act as a subject matter expert. Field questions and serve as a resource for clinicians and non-clinicians. Review and update job aids to maximize quality and produc..
- Hybrid Remote Work
- Full-Time
- Employee
- Urbana, IL
Provides healthcare to individuals, families, and communities within the RN scope of practice. Ensures adherence to established standards of care and scope of practice. Provides leadership for initiatives designed to improve the quality of care or...
- 100% Remote Work
- Alternative Schedule
- Employee
- Atlanta, GA
Provide telephonic support to participants, coordinate with healthcare team, identify risks for increasing acuity, facilitate educational opportunities, and ensure quality outcomes. Must possess a current RN license and have at least 3 years of recen..
- 100% Remote Work
- Alternative Schedule
- Employee
- Harrisburg, PA
Provide high-quality telephonic support to participants in a care enhancement program. Coordinate with healthcare team to ensure effective healthcare management and resource utilization. Identify and address participant needs and barriers to care.
- 100% Remote Work
- Alternative Schedule
- Employee
- US National
Provide telephonic support to participants, coordinate with healthcare team, and ensure high quality care. Identify educational needs, develop and implement care plans, and remove system barriers to access healthcare services.
- 100% Remote Work
- Alternative Schedule
- Employee
- Dover, DE
Provide telephonic support to patients, coordinate with healthcare team, identify educational needs, develop and implement care plans, and communicate with primary care providers. Requires RN license and 3 years clinical experience.
- 100% Remote Work
- Full-Time
- Employee
- 47.74 - 57.29 USD Hourly
- Pasadena, CA
Conduct home health nursing assessments and develop care plans. Deliver and document nursing interventions, educate participants and caregivers, and collaborate with the interdisciplinary team for smooth care transitions.
- 100% Remote Work
- Alternative Schedule
- Employee
- Springfield, IL, or US National
Provide telephonic support to participants, coordinate with the healthcare team to ensure quality care, identify barriers to healthcare access, and facilitate educational opportunities. Must be a licensed RN with 3 years of clinical experience.
- 100% Remote Work
- Alternative Schedule
- Employee
- Columbia, SC
Provide telephonic support for healthcare management. Develop and implement care plans, identify educational needs, and coordinate with healthcare providers. Requires RN license and 3 years of clinical experience.
- 100% Remote Work
- Alternative Schedule
- Employee
- Nashville, TN, or US National
Provide high-quality telephonic support to participants, coordinate with healthcare team, identify educational needs, develop and implement care plans, facilitate communication, and remove barriers to healthcare access.
- 100% Remote Work
- Alternative Schedule
- Employee
- Jefferson City, MO, or US National
The RN provides telephonic support, coordinates with the healthcare team, identifies educational needs, and implements care plans. Requires excellent listening skills, self-direction, 3 years of clinical experience, and current RN license.
- 100% Remote Work
- Alternative Schedule
- Employee
- Jackson, MS, or US National
Provide telephonic support to participants, coordinate with healthcare team, identify educational needs, and facilitate implementation of care plans. Requires RN license and 3 years of clinical experience.
- 100% Remote Work
- Full-Time
- Employee
- US National
Provide telephonic support to participants by assessing their healthcare needs, coordinating with healthcare team, and developing care plans. RNs must possess excellent listening skills and be highly organized. Must have a current RN license and...
- 100% Remote Work
- Alternative Schedule
- Employee
- Denver, CO, or US National
Achievement of clinical objectives by providing telephonic support, reviewing preventive health exams, contacting participants for assessment and intervention, facilitating educational opportunities, and coordinating with the healthcare team.
- 100% Remote Work
- Full-Time
- Employee
- Tucson, AZ
Manage high-risk cases in Pima/Pinal counties, AZ. Coordinate care, assess needs, make outbound/inbound calls, work with providers, and travel up to 50% of the time. Must have an AZ RN license and background in managed care. BSN and case management e..
- 100% Remote Work
- Alternative Schedule
- Employee
- 23.00 USD Hourly
- Atlanta, GA
Provide remote triage nursing care, including assessing patient needs, providing medical advice, and documenting patient information. Must have RN license, minimum 3 years of nursing experience, and be comfortable with technology and fast-paced...
- Hybrid Remote Work
- Alternative Schedule
- Employee
- 54,095.60 - 116,800 USD Annually
- High Point, NC, Winston-Salem, NC, Greensboro, NC
Assess, plan, implement, and coordinate case management activities. Conduct evaluations, develop proactive action plans, address barriers, and integrate strategies to enhance member wellness. Utilize clinical tools, review data, and collaborate with ..
- Hybrid Remote Work
- Full-Time
- Employee
- 71,000 - 73,000 USD Annually
- Summersville, WV
Provide in-home and telephonic care coordination, assess and create individualized care plans, coordinate health and social services, and conduct visits to hospitals and physicians' offices. RN license and case management experience required.
- Hybrid Remote Work
- Full-Time
- Employee
- 71,000 - 73,000 USD Annually
- McMechen, WV
Provide in-home and telephonic care coordination, assess and create individualized care plans, coordinate health and social services, conduct home visits, review care plans in regular conferences, ensure compliance with regulatory standards.
- Hybrid Remote Work
- Full-Time
- Employee
- Brick, NJ
Facilitate improvement in medical record documentation quality and accuracy. Review ED inpatient admissions for documentation completeness. Educate patient care team on guidelines. Communicate with physicians and coding staff for accurate documentation.
- 100% Remote Work
- Full-Time
- Employee
- 63,200.80 - 136,600 USD Annually
- US National
Assess, plan, implement, and coordinate all case management activities with members to evaluate their medical needs and facilitate their overall wellness. Utilize clinical tools and strategies to reduce risk factors and address complex health and soc..
- Hybrid Remote Work
- Full-Time
- Employee
- Pflugerville, TX
Implements staff development and clinical staff competency programs. Leverages creativity to present education and training programs. Evaluates staff development education and training programs. Provides job role training to learners for behavior and..
- 100% Remote Work
- Full-Time
- Employee
- 54,095.60 - 116,800.00 USD Hourly
- Tampa, FL
Responsible for assessing, planning, and coordinating healthcare services for pediatric members via phone and in-person. Use clinical judgment to address complex health needs and collaborate with interdisciplinary care team to ensure optimal outcomes..
- Hybrid Remote Work
- Full-Time
- Employee
- 28.03 - 54.95 USD Hourly
- Irvine, CA
As an RN Utilization Management, ensure compliance with guidelines and regulations for clinical decision-making. Compose denial letters, evaluate out-of-network and tertiary denials, and collaborate for continued quality improvement.
- 100% Remote Work
- Part-Time
- Employee
- 23.00 USD Hourly
- Tampa, FL
Provide compassionate and patient-centered triage care for hospice patients. Utilize technology to document calls and follow protocols. Must have experience in end-of-life care and be comfortable working in a fast-paced environment.
- 100% Remote Work
- Alternative Schedule
- Employee
- 23.00 - 23.00 USD Hourly
- Tampa, FL
Provide remote hospice triage nursing care to patients in a fast-paced environment. Utilize client-customized protocols for patient-centered, compassionate care. Must have experience in hospice, palliative, end-of-life care and high-speed internet.
- 100% Remote Work
- Full-Time
- Employee
- 60,522.80 - 129,600 USD Annually
- AZ, ID, UT, MT, WY, CO, NM, WA, OR, CA, NV
Serve as primary care manager for CVS Accountable Care members. Engage members telephonically to assess health status and manage difficult symptoms. Collaborate with care team to develop and implement a comprehensive care plan addressing physical, be..
- 100% Remote Work
- Full-Time
- Employee
- 60,522.00 - 129,600.00 USD Hourly
- OH
Assess, plan, implement, and coordinate case management activities with members to evaluate their medical needs. Develop proactive action plans, apply clinical judgment, and utilize case management processes to enhance member wellness.
- 100% Remote Work
- Full-Time
- Employee
- 74,000 - 90,000 USD Annually
- US National
Craft care plans, assess patients, outreach to clinics, manage panel, liaise with dialysis facilities, evaluate reports, provide culturally sensitive care. Req: Assoc. degree, RN license, 3+ yrs exp/cert. Salary: $74K-$90K.
- 100% Remote Work
- Full-Time
- Employee
- 58,300 - 114,300 USD Annually
- US National
Integrate diabetes management skills into clinical practice, advocate for improved care and outcomes for type 2 diabetes patients, participate in quality improvement processes, and deliver person-centered education for self-management.
- Part-Time
- Employee
- Duluth, MN
Organize and provide nursing care to patients, delegate care to other nursing personnel, contribute to meeting facility goals and regulatory requirements, and have experience in critical care nursing.
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