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Blue Cross Rn Remote Jobs in Ohio (NOW HIRING)

Formic

Automation Sales Manager

Cleveland, OH · Remote

Medical, dental, and vision insurance through Blue Cross Blue Shield and Unum, with 99% of employee ... A one-time allowance for fully remote and hybrid employees to support an at-home or on-the-road ...

Bcbsa

Senior Analyst, Rebate and Audit - SMC

Delaware, OH · Remote

$88K - $110K/yr

... a group of Blue Cross and Blue Shield affiliated companies to serve both Blues and select ... Reports to the Sr. Director, Trade Relations #LI-Remote $88,500.00 - $110,500.00 This is the lowest ...

New

Formic

Automation Sales Manager

Cincinnati, OH · Remote

Medical, dental, and vision insurance through Blue Cross Blue Shield and Unum, with 99% of employee ... A one-time allowance for fully remote and hybrid employees to support an at-home or on-the-road ...

Formic

Automation Sales Manager

Dayton, OH · Remote

Medical, dental, and vision insurance through Blue Cross Blue Shield and Unum, with 99% of employee ... A one-time allowance for fully remote and hybrid employees to support an at-home or on-the-road ...

Formic

Automation Sales Manager

Columbus, OH · Remote

Medical, dental, and vision insurance through Blue Cross Blue Shield and Unum, with 99% of employee ... A one-time allowance for fully remote and hybrid employees to support an at-home or on-the-road ...

Miamioh

Clinical Education Coordinator

Hamilton, OH · On-site +1

$85K/yr

Active, unencumbered registered nurse (RN) license in Ohio * Minimum of three years of clinical ... Remote work is not a right, it is a work arrangement that can be modified or revoked by Miami ...

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Blue Cross Rn Remote information

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 remote Blue Cross RN 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 Ohio? For Blue Cross Rn Remote jobs in Ohio, the most frequently searched job titles are:
What job categories do people searching Blue Cross Rn Remote jobs in Ohio look for? The top searched job categories for Blue Cross Rn Remote jobs in Ohio are:
What cities in Ohio are hiring for Blue Cross Rn Remote jobs? Cities in Ohio with the most Blue Cross Rn Remote job openings:
Blue Cross Rn Remote jobs near you
Clinical Financial Case Manager - RN - Escalation Lead

Clinical Financial Case Manager - RN - Escalation Lead

The Ohio State University

Columbus, OH • On-site, Remote

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

Screen reader users may encounter difficulty with this site. For assistance with applying, please contact hr-accessibleapplication@osu.edu. If you have questions while submitting an application, please review these frequently asked questions.
Current Employees and Students:
If you are currently employed or enrolled as a student at The Ohio State University, please log in to Workday to use the internal application process.
Welcome to The Ohio State University's career site. We invite you to apply to positions of interest. In order to ensure your application is complete, you must complete the following:
  • Ensure you have all necessary documents available when starting the application process. You can review the additional job description section on postings for documents that may be required.
  • Prior to submitting your application, please review and update (if necessary) the information in your candidate profile as it will transfer to your application.

Job Title:
Clinical Financial Case Manager - RN - Escalation Lead
Department:
Health System Shared Services | Revenue Cycle Clinical Support
The Clinical Financial Case Manager, RN - Escalation Lead provides advanced clinical appeal services with a focused responsibility for review and escalation of complex patient account denials. This role independently performs complex clinical reviews and evaluates relevant payer contractual terms and payer policies/guidelines to determine need for and method of escalation. The Lead will monitor and report on commercial and governmental payer denial trends and assist in the development of denial prevention strategies, while maintaining a caseload of standard appeals as needed.
In a leadership capacity, the Lead assists the Manager as clinical and operational resource for the clinical appeals team, supporting complex case resolution, payer policy interpretation, regulatory compliance, and technology-enabled workflows. The Lead monitors payer and regulatory updates, disseminating this information with the team. The Lead assists the Manager in evaluating workflows for effectiveness, and in supporting the adoption of new tools and systems.
The position assists the Manager in overseeing quality of clinical appeals and provides actionable quality assurance insights to management. The Lead also assists the Manager in monitoring productivity and performance trends. Through collaboration, coaching, and process improvement, the Lead aligns team operations with departmental goals, payer requirements, financial performance, and organizational technology initiatives.
MINIMUM REQUIRED QUALIFICATIONS
Bachelor's degree or equivalent experience. Registered Nurse. 2 years of relevant experience required. 2-4 years of relevant experience preferred.
Additional Information:
Location:
Remote Location
Position Type:
Regular
Scheduled Hours:
40
Shift:
First Shift
Final candidates are subject to successful completion of a background check. A drug screen or physical may be required during the post offer process.
Thank you for your interest in positions at The Ohio State University and Wexner Medical Center. Once you have applied, the most updated information on the status of your application can be found by visiting the Candidate Home section of this site. Please view your submitted applications by logging in and reviewing your status. For answers to additional questions please review the frequently asked questions.
The university is an equal opportunity employer, including veterans and disability.

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