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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 Virginia?

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

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

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

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

Cities in Virginia 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 Virginia as of September 2026, with employment types broken down into 83% Full Time, and 17% Contract. Highlights an 100% Remote job distribution.

Medical Policy Research Specialist/ Registered Nurse (RN) - Remote in Virginia

Sentara Health

Norfolk, VA • Remote

$10K/mo

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 7 days ago

Sentara Health rating

6.8

Company rating: 6.8 out of 10

Based on 417 frontline employees who took The Breakroom Quiz

496th of 898 rated healthcare providers

Job description

City/State
Norfolk, VA
Work Shift
First (Days)
Overview:
Sentara Health Plan is currently hiring a Medical Policy Research Specialist/ Registered Nurse (RN) - Remote in Virginia!
Status: Full-time, permanent position (40 hours)
Work hours: 8am to 5pm EST, M-F
Location: This position is remote in Virginia, with a travel expectation of 1x a month to Sentara Park 1330 in Virginia Beach, VA for candidates residing in the Hampton Roads area.
Job Responsibilities:
  • Medical Policy Research Specialist is responsible for ongoing identification and research of medically evidence-based clinical technologies that form the basis for clinical decision-making, medical policy and benefit development and determination.
  • Will maintain the database of clinical criteria, ensure technology and policy reviews are reviewed on an annual and ongoing basis to meet Federal, State and Accreditation Standards.
  • Will be proficient with the Healthcare Industry's changing National Guidelines, new medical treatments, and devices, and will compile information for the Plan related to clinical indications and use of the technology, alternative technologies that address these same indications, and clinical outcomes expected given the use of the technology.
  • Will perform a comprehensive clinical literature review, obtain legal and regulatory status of the technology, review Federal, State, and local coverage determinations, and identify current coverage policies and procedures.
  • Collaborates with Medical Directors and teams on clinical guideline/medical policy/regulatory guidance updates.

Education:
  • BLD - Bachelor's Level Degree in Nursing REQUIRED

Certificate/Licenses:
  • Active RN in VA or Compact/Multistate REQUIRED

Experience:
  • Related experience in clinical criteria coverage- 3 years REQUIRED
  • Managed Care - 3 years REQUIRED
  • Knowledge of medical policy, emerging technology, and analysis of emerging evidence REQUIRED
  • Familiarity with primary clinical literature, clinical guidelines and/or medical policies.
  • Working knowledge of PubMed and literature search methodology.
  • Experience with Imaging/Radiology preferred
  • Experience with policy writing process preferred
  • The ability to assimilate and work through data sets preferred

Sentara Health Plans provides health plan coverage to close to one million members in Virginia. We offer a full suite of commercial products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees.
Our quality provider network features a robust provider network, including specialists, primary care physicians and hospitals.
We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services-all to help our members improve their health.
Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.
Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!
To apply, please go to www.sentaracareers.com and use the following as your Keyword Search:JR-104961
Talroo-Nursing
Keywords: Managed Care, MCO, Health Insurance, Health Plan, Healthcare, Medical Policy, Research, Registered Nurse, RN, Nursing, Bachelor's, BSN,
Benefits: Caring For Your Family and Your Career
• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to $10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance - $5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down - $10,000
•Pet Insurance
•Legal Resources Plan
•Colleagues have the opportunity to earn an annual discretionary bonus ifestablished system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission “to improve health every day,” this is a tobacco-free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

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