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Blue Cross Rn Remote Jobs (NOW HIRING)

Nurse telephone Triage Service, LLC

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RN Triage Nurse - REMOTE

Charlotte, NC · Remote

$26/hr

This position is 100% remote***** Nurse Telephone Triage Service, LLC, a dynamic, fast growing triage company is seeking RNs with both pediatric and adult experience to join our team. And for those ...

KYYBA

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REMOTE RN CASE MANAGER

Detroit, MI · Remote

$35 - $39/hr

Case Manager RN -- Remote (Michigan) Contract: 12+ month contract with possible extension Work Arrangement: 100% remote License Requirement: Michigan State RN License 1. Mandatory Requirements to ...

Nurse telephone Triage Service, LLC

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RN Triage Nurse - REMOTE

Jacksonville, FL · Remote

$26/hr

This position is 100% remote***** Nurse Telephone Triage Service, LLC, a dynamic, fast growing triage company is seeking RNs with both pediatric and adult experience to join our team. And for those ...

Nurse telephone Triage Service, LLC

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RN Triage Nurse - REMOTE

Houston, TX · Remote

$26/hr

This position is 100% remote***** Nurse Telephone Triage Service, LLC, a dynamic, fast growing triage company is seeking RNs with both pediatric and adult experience to join our team. And for those ...

CareXM

Early Morning Triage Nurse - RN (Remote)

$26/hr

Early Morning Triage Nurse - RN (Remote) Pay: $26/hour Position Type: Part-Time / Early Mornings (20-24 hrs/wk) Training Schedule: The training is four weeks long. * You will meet each week, Monday ...

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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.
More about Blue Cross Rn Remote jobs
What cities are hiring for Blue Cross Rn Remote jobs? Cities with the most Blue Cross Rn Remote job openings:
What states have the most Blue Cross Rn Remote jobs? States with the most job openings for Blue Cross Rn Remote jobs include:
What job categories do people searching Blue Cross Rn Remote jobs look for? The top searched job categories for Blue Cross Rn Remote jobs are:
Blue Cross Rn Remote jobs near you
Infographic showing various Blue Cross Rn Remote job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 74% Full Time, 12% Part Time, and 13% Contract. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution.
BH UM Clinical Reviewer- Remote AZ

BH UM Clinical Reviewer- Remote AZ

Blue Cross Blue Shield of Arizona

Phoenix, AZ • On-site, Remote

Full-time

Posted 13 days ago

Blue Cross Blue Shield Of Arizona rating

5.9

Company rating: 5.9 out of 10

Based on 13 frontline employees who took The Breakroom Quiz

263rd of 281 rated insurance

Job description

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.
At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements:
  • Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week
  • Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week
  • Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per month
  • Onsite: daily onsite requirement based on the essential functions of the job
  • Remote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building

Please note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week.
This remote work opportunity requires residency, and work to be performed, within the State of Arizona.
Purpose of the job
Responsible for identifying, researching, processing, resolving and responding to inquiries from internal and external customers with emphasis on excellence, privacy, compliance and versatility within the health insurance industry. This job description is primary for utlization management functions but can assist with care management if a business need arises.
Qualifications
REQUIRED QUALIFICATIONS
Required Work Experience
  • 2 year(s) of experience in clinical field of practice, health insurance, or other health care related field

Required Education
  • Associate's Degree in general field of study or Post High School Nursing Diploma or Master's Degree in a behavioral health field of study (i.e., MSW, MA, MS, M.Ed.), Ph.D. or Psy.D.
Required Licenses
  • Active, current, and unrestricted license to practice in the State of Arizona (or an endorsement to work in Arizona) as a behavioral health professional such as LCSW, LPC, LISAC LMFT, or licensed psychologist (Psy.D. or Ph.D.), OR an active, current, and unrestricted license to practice nursing in either the State of Arizona or another state in the United States recognized by the Nursing Licensure Compact (NLC) as an RN.

Required Certifications
  • N/A

PREFERRED QUALIFICATIONS
Preferred Work Experience
  • 3 year(s) of experience in clinical field of practice, health insurance, or other health care related field
  • 1-2 year (s) of experience working in a managed care organization
Preferred Education
  • Bachelor's Degree in Nursing or related field of study
Preferred Licenses
  • Active, current, and unrestricted license to practice in the State of Arizona (a state in the United States) as a Registered Nurse
Preferred Certifications
  • N/A
ESSENTIAL job functions AND RESPONSIBILITIES
  • Identify, research, process, resolve and respond to customer inquiries and correspondence via telephone, written communication and/or in person.
  • Answer a diverse and high volume of health insurance related customer calls or correspondence daily.
  • Analyze medical records and apply medical necessity criteria and benefit plan requirements to determine the appropriateness of benefit requests.
  • Maintain complete and accurate records per department policy.
  • Meet quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines and required by State, Federal and other accrediting organizations.
  • Explain to customers a variety of information concerning the organization's services, including but not limited to, contract benefits, changes in coverage, eligibility, claims, BCBSAZ programs, provider networks, etc.
  • Demonstrate ability to apply plan policies and procedures effectively.
  • Consult and coordinate with various internal departments, external plans, providers, businesses, and government agencies to obtain information and ensure resolution of customer inquiries.
  • When indicated to assist with team/project functions:
    • Collaborate with team to distribute workload/work tasks.
    • Monitor and report team tasks.
    • Communicate team issues and opportunities for improvement to supervisor/manager;
    • Support/mentor team members.
  • Participate in continuing education and current developments in the fields of medicine, behavioral health and managed care at least annually.
  • Maintain all standards in consideration of State, Federal, BCBSAZ and other accreditation requirements.

  • The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.
  • Perform all other duties as assigned.
competencies
REQUIRED COMPETENCIES
Required Job Skills
  • Intermediate PC proficiency
  • Intermediate skill in use of office equipment, including copiers, fax machines, scanner and telephones

Required Professional Competencies
  • Maintain confidentiality and privacy
  • Strong current clinical knowledge
  • Practice interpersonal and active listening skills to achieve customer satisfaction
  • Compose a variety of business correspondence
  • Interpret and translate policies, procedures, programs and guidelines
  • Capable of investigative and analytical research
  • Navigate, gather, input and maintain data records in multiple system applications
  • Follow and accept instruction and direction
  • Establish and maintain working relationships in a collaborative team environment
  • Organizational skills with the ability to prioritize tasks and work with multiple priorities
  • Independent and sound judgment with good problem solving skills
Required Leadership Experience and Competencies
  • Resolve conflicts
  • Represent BCBSAZ in the community

PREFERRED COMPETENCIES
Preferred Job Skills
  • Advanced PC proficiency
  • Knowledge of CPT 2018 and ICD-10 coding
Preferred Professional Competencies
  • Knowledge of managed care, utilization management, and quality management
  • Working knowledge of McKesson InterQual® criteria, MCG, ASAM, or other nationally recognized criteria

Preferred Leadership Experience and Competencies
  • N/A

Our Commitment
AZ Blue does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.
Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. If interested in this position, please apply.

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