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Blue Cross Rn Remote Jobs in Fenton, MI (NOW HIRING)

Integral Blue

Project Manager

Auburn Hills, MI · On-site +1

$5.2K/mo

This position will work out of Integral Blue's Auburn Hills, Michigan office with remote work ... Analyze project requirements and collaborate with cross-functional teams to create competitive and ...

Formic

Automation Sales Manager

Detroit, MI · 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 ...

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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 Fenton, MI? For Blue Cross Rn Remote jobs in Fenton, MI, the most frequently searched job titles are:
What job categories do people searching Blue Cross Rn Remote jobs in Fenton, MI look for? The top searched job categories for Blue Cross Rn Remote jobs in Fenton, MI are:
What cities near Fenton, MI are hiring for Blue Cross Rn Remote jobs? Cities near Fenton, MI 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 Fenton, MI as of August 2026, with employment types broken down into 90% Full Time, 5% Part Time, and 5% Contract. Highlights an 100% Remote job distribution.

RN, telephonic Clinical Case Manager

Managed Medical Review Organization

Novi, MI • Remote

Full-time

Posted 13 days ago

Job description

About the Role
We are looking for an experienced RN Clinical Case Manager to support a disability claim review program. In this role, you will guide members through a collaborative case management process built on assessment, planning, care coordination, and ongoing evaluation. Your work directly supports improvement in members' (patients) disabling and co-morbid conditions and helps maximize their employability. You will own your caseload from start to finish and be responsible for an efficient, timely, and complete case management process.


What You'll Do
Determine the appropriate case management track for each assigned case.
Conduct telephonic clinical assessments covering activities of daily living, psycho-social factors, recent hospitalizations, current clinical status, treatment plans and medications, treating physicians, special needs, and the appropriate outreach interval for each case.
Develop customized, member-specific clinical case management plans.
Perform ongoing periodic telephonic outreach at intervals set during the initial clinical assessment.
Request and track receipt of the records and documentation needed to identify ongoing case management needs.
Build and maintain a case management resource library to provide members with information relevant to their conditions.
Assess whether a review is needed for a member's return to their own occupation, and identify the appropriate physician specialty when it is.
Collaborate with vocational specialists during the case management process when needed.
Conduct thorough, ongoing quality review of all case documentation and ensure completeness and accuracy of case paperwork.
Communicate with members, physicians, employers, and clients as appropriate.
Enter case activities into the case management system accurately and within client-required timeframes.
Maintain compliance with applicable practice standards and guidelines, including strict confidentiality and HIPAA adherence.


What You'll Bring
Unrestricted RN licensure, without sanctions.
Current certification in case management or a related field, or the ability to qualify for certification testing within six months of hire.
Minimum of five years of clinical experience.
Minimum of five years of case management experience in one or more of the following: medical, workers' compensation, auto, or disability case management.
Working knowledge of diagnostic coding (ICD-10).
Strong critical thinking, decision-making, and organizational skills with close attention to detail.
Ability to meet deadlines and turnaround times consistently.
Ability to work independently as well as within a team.
Computer literacy, including solid working knowledge of Microsoft Word and Excel.
Strong written, verbal, and telephonic communication skills, with the ability to manage multiple priorities.
Bachelor's degree in nursing or a health-related field.
Working knowledge of the insurance industry, medical claims, and/or disability claims.
Experience with Lean production management.


Work Environment
You will be working in an approved remote environment within the states of: Michigan, Illinois, Florida, Texas, or Minnesota. Stressful conditions may arise when the workload becomes more demanding than usual.

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