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Blue Cross Rn Remote Jobs in Fullerton, CA (NOW HIRING)

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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 Fullerton, CA?

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

What job categories do people searching Blue Cross Rn Remote jobs in Fullerton, CA look for?

The top searched job categories for Blue Cross Rn Remote jobs in Fullerton, CA are:

What cities near Fullerton, CA are hiring for Blue Cross Rn Remote jobs?

Cities near Fullerton, CA with the most Blue Cross Rn Remote job openings:

Infographic showing various Blue Cross Rn Remote job openings in Fullerton, CA as of August 2026, with employment types broken down into 80% Full Time, 10% Part Time, and 10% Contract. Highlights an 100% Remote job distribution.

Specialist, IRIS Eligibility Screening (Barron County, WI & Chippewa County, WI)

Molina Healthcare

Long Beach, CA • Remote

$19.84 - $38.69/hr

Full-time

Posted 11 days ago


Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 199 frontline employees who took The Breakroom Quiz

163rd of 306 rated insurance


Job description

Job Summary 

TMG is on the lookout for our next great Eligibility Screener! If you love doing meaningful work that helps others live their best lives, we want to hear from you!  

We're currently in search for someone with a background in human services, social work, healthcare or case management to join our team. This is a remote position, where you will partner with people in your community who use the TMG IRIS Consultant Agency. While this role is home-based, you will spend most days visiting IRIS participants in their homes. While you'll have a routine for the work that you do, no two days are alike!

As an Eligibility Screener, you would be responsible for completing the Adult Long-Term Care Functional Screens (LTC-FS) for participants of the Wisconsin IRIS program - a Medicaid long-term care option for older adults and people with disabilities. The job includes completing annual rescreens and any change-in-condition screens using the Adult LTC-FS tool to ensure program eligibility. Successful candidates will be approachable, compassionate and respectful of people of all different backgrounds and abilities, and be able to see and articulate the strengths that people inherently have.  

TMG is committed to maintaining a diverse and inclusive workforce, and prioritizes helping staff have a good work/life balance. Even though the position is remote, you'll have lots of support from your TMG team and coworkers across the organization. If this sounds like the job for you, apply today!

Job Duties 

  • Meets with IRIS participants face to face to complete the screening process. 
  • Completes the Adult Long Term Care Functional Screen (LTC-FS) for people in IRIS according to the Wisconsin Adult LTC-FS Instructions. 
  • Completes contacts to verify screen results with IRIS Consultants, Medicaid Personal Care agencies, and verifies diagnosis information with physicians and the Social Security Administration, when needed. 
  • Meets the highest standards of documentation and program regulations, while ensuring timely completion of  screens. 
  • Maintains screening skills by participating in weekly team meetings, monthly All Screener Meetings, trainings and testing. 
  • Other duties as assigned by management. 

Required Qualifications


1 year of experience serving target groups of the IRIS program (adults with physical/intellectual disabilities or older adults), or equivalent combination of relevant education and experience. 
Must be currently certified to conduct/administer the adult long-term care functional screens or pass the Wisconsin adult long-term care functional screen certification modules (80% or higher on each module) within first week of hire and maintain certification as a screener. 
Bachelor of arts or science degree or more advanced degree in a health or human services related field (e.g. social work, psychology) or graduate from an accredited school of nursing. 
If a graduate from an accredited school of nursing, must have an active and unrestricted Wisconsin Registered Nurse (RN) license in good standing. 
Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements. 
Attention to detail and ability to ensure accuracy of data. 
Strong organizational and time-management skills. 
Strong customer service skills and the ability to work cooperatively as part of a team and independently. 
Ability to remain flexible in the work environment and willing and able to adapt to changing organizational needs. 
Excellent verbal and written communication skills. 
Demonstrated computer and software skills required including Microsoft Office suite/applicable software program(s) proficiency. 
Travel Requirements 5%.

Preferred Qualifications


Current or former certification to conduct/administer adult Long-Term Care Functional Screening (LTCFS) in the state of Wisconsin.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. 
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $19.84 - $38.69 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Employment Type: Full Time

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About Molina Healthcare

Sourced by ZipRecruiter

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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