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Blue Cross Rn Remote Jobs in Oregon (NOW HIRING)

Imagine Pediatrics

Bilingual Pediatric Registered Nurse

OR · On-site +1

$40 - $47/hr

The primary location for this position is remote (CST required), with a strong preference of those ... Nurses must physically be working in the United States. What You'll Do As a Pediatric Registered ...

New

Formic

Automation Sales Manager

Portland, OR · 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 ...

Healthcare Support Staffing

Remote HEDIS Specialist

OR · On-site +1

Must be bilingual, fluent in Spanish, they will be remote workers supporting Molina Puerto Rico Licensed RN/LVN/LPN HEDIS knowledge Ability to read and understand medical records Independent and able ...

Cambia Health Solutions

Payment Integrity Nurse I

Bend, OR · Remote

$66K - $106K/yr

Bachelor's degree (or higher) in a health or human services-related field (psychiatric RN or ... Remote Pay ranges vary based on the candidate's work location. The expected hiring range depends on ...

Umpqua Health

Utilization Review Clinician

Roseburg, OR · On-site +1

$80K - $94K/yr

UTILIZATION REVIEW CLINICIAN REMOTE Ability to travel on-site to 3031 NE STEPHENS ST. ROSEBURG, OR ... Licensed Marriage and Family Therapist (LMFT) * Registered Nurse (RN) with Behavioral Health ...

PRO-spectus

Case Manager - RN, Oncology

OR · On-site +1

Oncology RN experience highly desired. * Experience with complex medical products and associated ... As a remote-forward organization, this position operates in a professional office environment and ...

Lumimeds

Healthcare Content Creator (LP/NP/RN/PA/MD)

OR · On-site +1

LP (Licensed Pharmacist), NP (Nurse Practitioner), RN (Registered Nurse), PA (Physician Assistant ... Fully remote, U.S.-based * Time commitment: ~4-10 hours/month, flexible scheduling around shoots ...

Centene

Clinical Appeals Coordinator

OR · On-site +1

$33.71 - $60.67/hr

License/Certification: LPN, LVN, or RN license. Specialty Therapy Requirement: Master's degree in ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

ZoomCare

Psychiatric Nurse Practitioner

Portland, OR · On-site +1

$140K - $163K/yr

Remote Schedule (Must be located in Oregon) ESSENTIAL FUNCTIONS Reasonable accommodations may be ... Current Registered Nursing licensure in Oregon and Washington. * Master of Science in Nursing (MSN ...

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Blue Cross Rn Remote information

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 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 are popular job titles related to Blue Cross Rn Remote jobs in Oregon?

For Blue Cross Rn Remote jobs in Oregon, the most frequently searched job titles are:

What job categories do people searching Blue Cross Rn Remote jobs in Oregon look for?

The top searched job categories for Blue Cross Rn Remote jobs in Oregon are:

What cities in Oregon are hiring for Blue Cross Rn Remote jobs?

Cities in Oregon 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 Oregon as of August 2026, with employment types broken down into 84% Full Time, 11% Part Time, and 5% Contract. Highlights an 100% Remote job distribution.

Utilization Management Program Manager-RN

Samaritan Health Services

Eugene, OR • Remote

Full-time

Re-posted 11 days ago

Samaritan Health Services rating

7.5

Company rating: 7.5 out of 10

Based on 65 frontline employees who took The Breakroom Quiz

236th of 888 rated healthcare providers

Job description

Summary


  • Samaritan Health Plans (SHP) provides health insurance options to Samaritan employees, community employers, and Medicare and Medicaid members. SHP operates a portfolio of health plan products under several different legal structures: InterCommunityHealth Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans. As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services' mission of Building Healthier Communities Together. This is a remote position in which we are able to employ in the following states: Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin Our ideal candidate will have the following experience:
    • Health plan utilization management
    • Medicare and Medicaid rules and regulations and health plan benefit structure and policy.
    • Data analysis to include reporting results and developing improvement plans
    • Quality Management experience in a healthcare setting

  • JOB SUMMARY/PURPOSE

    • Executes program(s) that meet the needs of the organization, employees and/or customers. Plans, initiates, oversees execution of all elements for assigned program(s). Leads the development, implementation and management of assigned program(s) and associated projects. Oversees process from planning to completion. Works with multiple internal teams, vendors, clients. Responsible for explaining, training, and mentoring the entire organization on the program. Collaborates with SHS system experts to ensure focus, alignment, and best practices for the program.
  • EXPERIENCE/EDUCATION/QUALIFICATIONS
    • Current unencumbered Oregon RN License required within 90 days of hire. BSN preferred. Master's degree in a related field preferred.
    • One (1) year clinical nursing experience plus four (4) years health plan utilization management experience required.
    • Experience or training in the following required:
      • Health care delivery systems and/or managed care patients.
      • Computer applications including electronic documentation (e.g., MS Office, EPIC, Clinical Care Advanced).
    • Experience in the following preferred:
      • Team leadership.
      • Case management.
      • Medicare and Medicaid rules and regulations and health plan benefit structure and policy.
  • KNOWLEDGE/SKILLS/ABILITIES
    • Leadership - Inspires, motivates, and guides others toward accomplishing goals. Achieves desired results through effective people management.
    • Conflict resolution - Influences others to build consensus and gain cooperation. Proactively resolves conflicts in a positive and constructive manner.
    • Critical thinking – Identifies complex problems. Involves key parties, gathers pertinent data and considers various options in decision making process. Develops, evaluates and implements effective solutions.
    • Communication and team building – Lead effectively with excellent verbal and written communication. Delegates and initiates/manage cross-functional teams and multi-disciplinary projects.
  • PHYSICAL DEMANDS
    • (1 - 10% of the time) (11 - 33% of the time) (34 - 66% of the time) (67 – 100% of the time) LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs LIFT (Knee to chest: 24"-54") 0 – 20 Lbs LIFT (Waist to Eye: up to 54") 0 - 20 Lbs CARRY 1-handed, 0 - 20 pounds BEND FORWARD at waist KNEEL (on knees) WALK – LEVEL SURFACE ROTATE TRUNK Standing REACH - Upward PUSH (0 - 20 pounds force) PULL (0 - 20 pounds force) CARRY 2-handed, 0 - 20 pounds ROTATE TRUNK Sitting REACH - Forward FINGER DEXTERITY PINCH Fingers GRASP Hand/Fist

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