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Blue Cross Rn Remote Jobs in Missouri (NOW HIRING)

Far West Local Health District

$9.0K/mo

Remote Area Housing Benefit * Isolation & climate allowance * Corporate rates at local gym (YMCA ... Current Authority to practice as a Registered Nurse with the Australian Health Practitioner ...

Far West Local Health District

$9.0K/mo

Remote Area Housing Benefit * Isolation & climate allowance * Corporate rates at local gym (YMCA ... Current Authority to practice as a Registered Nurse with the Australian Health Practitioner ...

BetterHelp

Clinical Psychologist- Remote

Kansas City, MO · Remote

$67K - $83K/yr

Work from the comfort of home (fully remote) * Flexible schedule - you set your own hours. * Free ... Also, we are unable to accept substance abuse counselors, school counselors, registered nurses ...

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Blue Cross Rn Remote information

What can I do as a Blue Cross RN that isn't bedside?

A Blue Cross RN can work in case management, telehealth, health coaching, or utilization review, which involve coordinating care, providing patient education remotely, and assessing medical necessity. These roles typically require strong communication skills, clinical knowledge, and sometimes additional certifications, allowing nurses to work outside of direct patient bedside care.

What are the key skills and qualifications needed to thrive as a Blue Cross RN remote, and why are they important?

To excel as a Blue Cross RN Remote, you need an active RN license, clinical nursing experience (often in case management or utilization review), and strong assessment abilities. Familiarity with electronic medical record (EMR) systems, telehealth platforms, and case management software is typically required, along with certifications like CCM (Certified Case Manager) being advantageous. Exceptional communication, self-motivation, and organizational skills help nurses effectively support members and collaborate virtually with healthcare teams. These competencies ensure quality patient care, regulatory compliance, and efficient service delivery in a remote environment.

What is the difference between Blue Cross Rn Remote vs Blue Cross Lpn Remote?

AspectBlue Cross Rn RemoteBlue Cross Lpn Remote
Required CredentialsRegistered Nurse (RN) licenseLicensed Practical Nurse (LPN) license
Work EnvironmentRemote healthcare support, patient assessmentsRemote patient care, basic clinical tasks
Employer & Industry UsageHealth insurance companies, healthcare providersHealth insurance companies, healthcare providers
Common Search & ComparisonYesYes

Blue Cross Rn Remote and Blue Cross Lpn Remote roles both serve in remote healthcare settings within insurance companies and healthcare providers. The main difference lies in the required credentials: RNs need a registered nurse license, while LPNs require a practical nurse license. RNs typically handle more complex patient assessments, whereas LPNs focus on basic patient care tasks. Both roles are essential in remote healthcare support, but they differ in scope and qualification requirements.

What is a Blue Cross RN remote?

A Blue Cross RN Remote is a registered nurse who works remotely for Blue Cross Blue Shield, typically supporting members through telehealth, case management, care coordination, and health coaching. These nurses use phone, video calls, and digital platforms to assess patient needs, develop care plans, and provide education and support. Their role helps ensure that members receive high-quality care and guidance without needing in-person visits, making healthcare more accessible and convenient. Blue Cross RNs working remotely may also assist with pre-authorization, utilization management, or disease management programs.

How does a Blue Cross RN remote typically communicate and coordinate care with interdisciplinary team members?

As a remote Blue Cross RN, effective communication with physicians, case managers, social workers, and other healthcare professionals is essential. Most coordination occurs via secure digital platforms, video calls, and phone conferences, allowing for timely updates on patient progress and care plans. Regular virtual meetings and documentation in shared electronic health records ensure seamless teamwork and continuity of care. Building strong digital communication skills and being proactive about follow-ups are key to success in this remote setting.
What are popular job titles related to Blue Cross Rn Remote jobs in Missouri? For Blue Cross Rn Remote jobs in Missouri, the most frequently searched job titles are:
What job categories do people searching Blue Cross Rn Remote jobs in Missouri look for? The top searched job categories for Blue Cross Rn Remote jobs in Missouri are:
What cities in Missouri are hiring for Blue Cross Rn Remote jobs? Cities in Missouri with the most Blue Cross Rn Remote job openings:
Blue Cross Rn Remote jobs near you
Infographic showing various Blue Cross Rn Remote job openings in Missouri as of August 2026, with employment types broken down into 2% Internship, 77% Full Time, 17% Part Time, and 4% Contract. Highlights an 100% Remote job distribution.

Supervisor, Utilization Management (RN)

Centene

Saint Louis, MO • On-site, Remote

$75K - $135K/yr

Full-time, Part-time

Medical, Retirement, PTO

Posted 18 days ago

Centene rating

8.4

Company rating: 8.4 out of 10

Based on 402 frontline employees who took The Breakroom Quiz

23rd of 887 rated healthcare providers

Job description

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: Supervises Prior Authorization, Concurrent Review, and/or Retrospective Review Clinical Review team to ensure appropriate care to members. Supervises day-to-day activities of utilization management team.
  • Monitors and tracks UM resources to ensure adherence to performance, compliance, quality, and efficiency standards
  • Collaborates with utilization management team to resolve complex care member issues
  • Maintains knowledge of regulations, accreditation standards, and industry best practices related to utilization management
  • Works with utilization management team and senior management to identify opportunities for process and quality improvements within utilization management
  • Educates and provides resources for utilization management team on key initiatives and to facilitate on-going communication between utilization management team, members, and providers
  • Monitors prior authorization, concurrent review, and/or retrospective clinical review nurses and ensures compliance with applicable guidelines, policies, and procedures
  • Works with the senior management to develop and implement UM policies, procedures, and guidelines that ensure appropriate and effective utilization of healthcare services
  • Evaluates utilization management team performance and provides feedback regarding performance, goals, and career milestones
  • Provides coaching and guidance to utilization management team to ensure adherence to quality and performance standards
  • Assists with onboarding, hiring, and training utilization management team members
  • Leads and champions change within scope of responsibility
  • Performs other duties as assigned
  • Complies with all policies and standards

Education/Experience: Requires Graduate of an Accredited School Nursing or Bachelor's degree and 4+ years of related experience.
Knowledge of utilization management principles preferred.
License/Certification:

  • RN - Registered Nurse - State Licensure and/or Compact State Licensure required
  • CA RN LICENSE REQUIRED
Pay Range: $75,300.00 - $135,400.00 per year

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.


Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Powered by SonicJobs (an advertiser on Veritone). By applying, you consent to share your data with SonicJobs and the employer. Veritone or SonicJobs does not store or use your application data beyond facilitating the application.
See Centene Terms & Conditions at https://www.centene.com/terms-conditions.html and Privacy Policy at https://www.centene.com/privacy-policy.html and SonicJobs Privacy Policy at https://www.sonicjobs.com/us/privacy-policy and Terms of Use at https://www.sonicjobs.com/us/terms-conditions

PandoLogic. Keywords: Utilization Review Supervisor, Location: St. Louis, MO - 63110

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