ZipRecruiter

Log In

2

Blue Cross Rn Remote Jobs in Needham, MA (NOW HIRING)

VIVA USA INC

Nurse Case Manager

Woonsocket, RI · On-site +1

Case Management Certification CCM preferred Requires an RN with unrestricted active license in Georgia. REQUIRED : Must have experience working a remote position previously. Must have case management ...

VIVA USA INC

Nurse Case Manager

Woonsocket, RI · On-site +1

Case Management Certification CCM preferred Requires an RN with unrestricted active license in Georgia. REQUIRED : Must have experience working a remote position previously. Must have case management ...

VITRA Health

Nurse Compliance Manager

Boston, MA · Remote

$140K - $150K/yr

This role requires a strong clinical background (RN required), deep knowledge of healthcare ... Conduct and supervise onsite and remote audits of field operations, caregiver performance, and ...

Sedgwick

RN Field Case Manager

Boston, MA · Remote

$84K - $107K/yr

Must be an RN and prefers 1.5 years of prior workers compensation experience. PRIMARY PURPOSE OF ... remote work environment that allows face to face interaction with injured workers and medical ...

York Risk Services

RN Field Case Manager

Boston, MA · Remote

$84K - $107K/yr

Must be an RN and prefers 1.5 years of prior workers compensation experience. PRIMARY PURPOSE OF ... remote work environment that allows face to face interaction with injured workers and medical ...

next page

Showing results 1-20

All JobsBlue Cross Rn Remote JobsBlue Cross Rn Remote Jobs in Needham, MA

Blue Cross Rn Remote information

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 remote Blue Cross RN 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 Needham, MA? For Blue Cross Rn Remote jobs in Needham, MA, the most frequently searched job titles are:
What job categories do people searching Blue Cross Rn Remote jobs in Needham, MA look for? The top searched job categories for Blue Cross Rn Remote jobs in Needham, MA are:
What cities near Needham, MA are hiring for Blue Cross Rn Remote jobs? Cities near Needham, MA with the most Blue Cross Rn Remote job openings:
Blue Cross Rn Remote jobs near you
Clinical Documentation Integrity Specialist- RN- Remote

Clinical Documentation Integrity Specialist- RN- Remote

Beth Israel Lahey Health

Burlington, MA • Remote

$76K - $103K/yr

Full-time

Posted 23 days ago

Beth Israel Lahey Health rating

6.9

Company rating: 6.9 out of 10

Based on 148 frontline employees who took The Breakroom Quiz

444th of 877 rated healthcare providers

Job description

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.

**This position is remote. Candidates must be local to New England States for consideration**
The Clinical Documentation Improvement (CDI) Specialist Registered Nurse (RN) assists with the appropriate identification of diagnoses, conditions, and/or procedures that are representative of the patient’s hospital stay and care provided including Severity of Illness (SOI), Risk of Morality (ROM), during an inpatient hospitalization. CDI Specialist RN initiates concurrent queries to providers as supported by medical record documentation to improve the accuracy, integrity, and quality of patient data, and drive improvement toward quality physician documentation within the body of the medical record. The CDI Specialist RN works under the direction of the Manager of CDI and collaborates with coding, clinicians, medical staff, and physician advisors to improve documentation and the importance of complete and accurate documentation.

Job Description:

Essential Duties & Responsibilities including but not limited to:

Completes initial reviews of patient records within 24-48 hours of admission

Evaluate documentation to assign the principal diagnosis, pertinent secondary diagnoses, and procedures for accurate DRG assignment, risk of morality, and severity of illness.

Track review details in 3M software.

Conducts follow-up reviews of patients every 2 days to support and assign a working DRG assignment. Queries physicians regarding missing, unclear, or conflicting medical record documentation by requesting and obtaining additional documentation within the medical record when needed. Educates physicians and key healthcare providers regarding clinical documentation improvement and the need for accurate and complete documentation in the medical record. Collaborates with the CDI Manager & Physician Advisor and other ancillary staff regarding interaction with physicians on documentation and to resolve physician queries prior to patient discharge. Educates members of the patient care team regarding documentation opportunities and best practices to ensure accurate documentation in the medical record. Applies diplomacy and professionalism when interacting with physicians and clinicians; especially when addressing missing or conflicting medical record information. Works in partnership with an interdisciplinary team to foster collaboration, learning, and accurate and complete medical record documentation. Exhibits working knowledge of inpatient coding guidelines. Adheres to CDI convention and department policies and procedures. Investigates, evaluates, and identifies opportunities for improvement and recognizes their relative significance in the overall system. Provides orientation for new clinical staff regarding documentation requirements as required. Keeps current with CDI concepts and practices through conferences, reference material, and review of current literature. Maintains confidentiality of all customer/hospital information. Demonstrates flexibility in the face of a changing work environment, adjusting work schedule accordingly.

Minimum Qualifications:

Education:

  • Associate’s degree required. Bachelor's degree preferred.
  • Licensure, Certification & Registration:
  • RN license required

Experience:

  • 3-5 years of related work experience required in a clinical nursing practice, which includes medical, surgical, and/or ICU background.

Skills, Knowledge & Abilities:

  • Experience with computer systems required, including web-based applications and some Microsoft Office applications which may include Outlook, Word, Excel, PowerPoint, or Access

Preferred Qualifications & Skills:

  • BS in Nursing with 5-8 years of acute care clinical experience.
  • Certified Clinical Documentation Specialist (CCDS) or Certified Clinical Documentation Improvement Professional (CDIP)
  • Experience with DRG Reimbursement and ICD-10 Coding

Pay Range:

$76,960.00 USD - $103,578.00 USD

The pay range listed for this position is the annual base salary range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law. 

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment. More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger. Equal Opportunity Employer/Veterans/Disabled

What Beth Israel Lahey Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply