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

Vynca

Manager, Case Management (RN)

San Mateo, CA · Remote

$90K - $125K/yr

Remote with up to 25% travel - must be based in one of the following states: Arizona, California ... Active, unrestricted RN license with the ability to obtain California licensure within 6 months of ...

SimX, Inc

Territory Manager (Remote)

San Francisco, CA · Remote

$70K - $90K/yr

... industry (RN, EMT, Paramedic, PA, MD, DO, etc). Degree in marketing, communications, business ... Remote work environment SimX covers 99% of employee premiums and 50% of dependent premiums for ...

JDA

Sr Technical Architect - Supply chain

Palo Alto, CA · On-site +1

$100K - $143K/yr

Dallas, TX ( REMOTE role) Company Overview: Blue Yonder is a global leader in digital supply chain ... Lead the design and development of complex cross-product features and solutions. * Ensure the ...

CareDx, Inc.

Clinical Trial Manager

Brisbane, CA · Remote

... RN or pharmaceutical experience preferred but not required. * Minimum of 4 years of clinical trial management and 2+ years clinical research associate with on-site/remote clinical monitoring ...

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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 Hayward, CA?

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

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

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

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

Cities near Hayward, CA 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 Hayward, CA as of August 2026, with employment types broken down into 68% Full Time, and 32% Contract. Highlights an 100% Remote job distribution.

RN- Care Review Clinician- UM/Discharge Planning (Remote- CA License Req)

Molina Healthcare

San Francisco, CA • Remote

$30.37 - $59.21/hr

Full-time

Re-posted 23 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 199 frontline employees who took The Breakroom Quiz

171st of 315 rated insurance

Job description

JOB DESCRIPTION Job Summary

Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care. 
Essential Job Duties 
• Assesses services for members to ensure optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines. 
• Analyzes clinical service requests from members or providers against evidence based clinical guidelines. 
• Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures. 
• Conducts reviews to determine prior authorization/financial responsibility for Molina and its members. 
• Processes requests within required timelines. 
• Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner. 
• Requests additional information from members or providers as needed. 
• Makes appropriate referrals to other clinical programs. 
• Collaborates with multidisciplinary teams to promote the Molina care model. 
• Adheres to utilization management (UM) policies and procedures. 
Required Qualifications 
• At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience. 
• Registered Nurse (RN). License must be active and unrestricted in state of practice. 
• Ability to prioritize and manage multiple deadlines. 
• Excellent organizational, problem-solving and critical-thinking skills. 
• Strong written and verbal communication skills. 
• Microsoft Office suite/applicable software program(s) proficiency. 
Preferred Qualifications 
Certified Professional in Healthcare Management (CPHM). 

Utilization review, prior authorization, inpatient review desirable. MCG experience, strongly preferred.
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: $30.37 - $59.21 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

What Molina Healthcare employees say

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Benefits

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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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