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Blue Cross Rn Remote Jobs in Topeka, KS (NOW HIRING)

LMH Health

Coder

Lawrence, KS · Remote

Will be cross-trained to assist with backlog in any needed focus-coding group. * Work cooperatively ... This position is entirely remote or work from home following completing of onboarding training ...

Lantern

Strategy Analyst

Topeka, KS · Remote

Lantern also pairs members with a dedicated care team, including Care Advocates and nurses, for the ... This is a remote-first role with occasional (~1x month) travel. Responsibilities and Duties:

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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 Topeka, KS?

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

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

The top searched job categories for Blue Cross Rn Remote jobs in Topeka, KS are:

What cities near Topeka, KS are hiring for Blue Cross Rn Remote jobs?

Cities near Topeka, KS 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 Topeka, KS as of August 2026, with employment types broken down into 83% Full Time, and 17% Contract. Highlights an 100% Remote job distribution.

Risk Adjustment Quality Specialist

LMH Health

Lawrence, KS • On-site, Remote

Full-time

Re-posted 4 days ago

Job description

Something special starts here.

You can't define it, but you know it when you see it: the difference between an average life and the good life. When your cup is full - with joy, purpose and lifelong health - it shows. At LMH Health, we are all about healthy people, healthy communities and healthy futures, and that makes us your destination for an exceptional career. From flexible, work-life harmony to competitive pay and great advancement potential, find everything you're looking for at LMH Health.


You'll find everything you're looking for at LMH Health:

  • Join a team that cares about the community
  • Tuition reimbursement to support continuing education
  • Professional development and recognition
  • Excellent benefits


We're looking for you.

Job Description

I. JOB SUMMARY

The Risk Adjustment Quality Specialist plays a vital role in coordinating and supporting prospective, concurrent, and retrospective reviews to assist with patient care management. The position provides education and facilitates chart retrieval for Health Plan audits and reports. This position requires a comprehensive understanding of Hierarchical Condition Categories (HCC) coding to accurately translate, input, extract, and validate medical record data.

This role assists with monitoring quality program performance, including tracking, reporting, and implementation of best practices and program requirements.
II. ESSENTIAL JOB RESPONSIBILITIES

  • Perform comprehensive reviews of patient medical records for documentation consistency and adequacy to identify all appropriate coding based on Centers for Medicare & Medicaid Services (CMS) HCC categories.
  • Monitor revenue opportunities related to value-based care.
  • Manage the provider query process to clarify documentation and ensure the completeness and accuracy of patient diagnoses, particularly related to chronic conditions.
  • Utilize evidence based practices to provide providers with targeted feedback and education on improving documentation and coding accuracy, specifically related to HCC.
  • Demonstrate analytical and problem-solving ability with regard to barriers in receiving and validating accurate HCC information.
  • Analyze performance data to identify trends, gaps, and opportunities for improvement.
  • Maintains intermediate to advanced understanding of claims processing procedures, state and federal regulations, and Medicare Part D requirements.
  • Utilize coding software to ensure compliance with Medicare, Medicaid, and other payer requirements.
  • Collaborate with medical staff to clarify documentation and support accurate coding and reimbursement.
  • Participate in audits, quality reviews, and continuous improvement initiatives.
  • Educate staff on coding practices and HCC assignments.
  • Maintain compliance with policies, procedures, and continuing education requirements.
  • Performs other duties as needed or assigned.

III. JOB QUALIFICATIONS

Required:

  • Minimum of 3 years of experience in medical coding or risk adjustment with a focus on Hierarchical Care Conditions, value based care contracts, and accountable care organizations.
  • Strong knowledge of CMS risk adjustment and quality initiatives, including Hierarchical Condition Categories (HCCs).
  • Completion of one of the following through AHIMA accredited programs: Certificate Coding Associate, Certificate Coding Specialist, Certified Professional Coder, Registered Health Information Technician, Registered Health Information Administrator
    OR
  • Credentialed through AAPC

Preferred:

  • Registered Nurse
  • Associates or Bachelor's Degree in Health Information Management
  • 3M Coding Solution Knowledge

Remote Work/Work-from-Home:

This position has hybrid work flexibility. This person must live within Kansas or Missouri, and will be required attend on-site meetings, as scheduled.

Our Cultural Beliefs
  • People First
  • Integrity Matters
  • Better Together

At LMH Health,we value inclusion and diversity. We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.

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