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Remote Hcbs Jobs (NOW HIRING)

ORAU

Senior Advisor- Payment Design

$56.89 - $68/hr

Remote Salary: $56.89 - $68.00 per hour Summary ORAU seeks an experienced Senior Advisor with deep ... pricing, and HCBS payment methodologies. • Understanding of Medicare payment systems, CMS ...

Humana

Care Coordinator, RN Field Based

Lagrange, IN · Remote

Prior management of Home and Community Based Services waivers (HCBS dual roles only) * Prior ... Combination remote work at home and onsite member visits Location: Must reside in Indiana Hours:

Humana

Care Coordinator, RN Field Based

Franklin, IN · Remote

Prior management of Home and Community Based Services waivers (HCBS dual roles only) * Prior ... Combination remote work at home and onsite member visits Location: Must reside in Indiana Hours:

Humana

Care Coordinator, RN Field Based

Wabash, IN · Remote

Prior management of Home and Community Based Services waivers (HCBS dual roles only) * Prior ... Combination remote work at home and onsite member visits Location: Must reside in Indiana Hours:

Humana

Care Coordinator, RN Field Based

Speedway, IN · Remote

Prior management of Home and Community Based Services waivers (HCBS dual roles only) * Prior ... Combination remote work at home and onsite member visits Location: Must reside in Indiana Hours:

Humana

Care Coordinator, RN Field Based

Lawrence, IN · Remote

Prior management of Home and Community Based Services waivers (HCBS dual roles only) * Prior ... Combination remote work at home and onsite member visits Location: Must reside in Indiana Hours:

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Remote Hcbs information

What are Remote HCBS jobs?

Remote HCBS jobs involve providing Home and Community-Based Services (HCBS) support to individuals with disabilities or aging adults, but with duties performed remotely rather than in person. These roles may include care coordination, case management, service planning, and client support, all handled via phone, video calls, or online platforms. The goal is to help clients live independently in their homes and communities while ensuring they receive the services and resources they need. Remote HCBS positions often require strong communication skills, knowledge of Medicaid or related programs, and the ability to use technology effectively.

What are the biggest challenges of working remotely as an HCBS (Home and Community-Based Services) case manager, and how can they be managed?

One of the main challenges of working remotely as an HCBS case manager is maintaining consistent and effective communication with clients, families, and service providers. Building rapport and assessing client needs can be more difficult without in-person visits. To manage these challenges, remote HCBS professionals often rely on regular video calls, detailed electronic documentation, and close collaboration with local providers. Proactive scheduling, clear communication protocols, and utilizing available digital tools can help ensure clients continue to receive high-quality, person-centered care.

What are the key skills and qualifications needed to thrive as a Remote HCBS (Home and Community-Based Services) Coordinator, and why are they important?

To thrive as a Remote HCBS Coordinator, you need a solid understanding of care coordination, case management, and regulations surrounding Medicaid and HCBS programs, often supported by a degree in social work, nursing, or a related field. Familiarity with case management software, telehealth platforms, and secure documentation systems is typically required. Excellent communication, organization, and empathy set top performers apart when supporting clients and collaborating with providers remotely. These skills ensure efficient service delivery, regulatory compliance, and positive client outcomes in a virtual care environment.

What is the difference between Remote Hcbs vs Remote Care Coordinators?

AspectRemote HcbsRemote Care Coordinators
CredentialsTypically requires healthcare-related certifications or licensesOften requires healthcare or social work background, certifications vary
Work EnvironmentRemote, healthcare provider settings, community-basedRemote, healthcare organizations, insurance companies
Employer & IndustryHealth plans, Medicaid/Medicare providers, community agenciesHealth plans, insurance companies, healthcare organizations

Remote Hcbs (Home and Community-Based Services) professionals focus on providing in-home support and services, often requiring healthcare certifications. Remote Care Coordinators manage patient care plans, coordinate services, and often have healthcare or social work backgrounds. Both roles are remote, serve the healthcare industry, and involve supporting patient needs, but they differ in specific responsibilities and required credentials.

More about Remote Hcbs jobs
What cities are hiring for Remote Hcbs jobs? Cities with the most Remote Hcbs job openings:
What are the most commonly searched types of Hcbs jobs? The most popular types of Hcbs jobs are:
What states have the most Remote Hcbs jobs? States with the most job openings for Remote Hcbs jobs include:
What job categories do people searching Remote Hcbs jobs look for? The top searched job categories for Remote Hcbs jobs are:
Remote Hcbs jobs near you

Remote Compliance Auditor

The CKHobbie Group

Harrisburg, PA • On-site, Remote

Full-time

Posted 4 days ago

Job description

Job Description
Position Overview:
We are seeking a Registered Nurse (RN) to review and evaluate medical necessity, appropriateness, quality, and compliance of services rendered by providers. This role involves claims analysis, provider audits, fraud detection, and regulatory enforcement to ensure compliance with state and federal regulations.
Key Responsibilities:
  • Analyze claims data, medical records, and provider documentation to identify discrepancies, fraud, or non-compliance.
  • Conduct retrospective case reviews, on-site provider audits, and recipient interviews.
  • Review billing practices for upcoding, duplicate billing, and unbundling of services using ICD-10, CPT, and HCPCS manuals.
  • Prepare reports, case findings, and recommend sanctions when violations are identified.
  • Coordinate and participate in teleconferences, hearings, and legal proceedings with the Office of General Counsel and other agencies.
  • Respond to provider complaints and compliance inquiries via hotline, email, and official reports.
  • Maintain case tracking systems and contribute to policy recommendations and process improvements.
  • Travel as needed for on-site reviews, meetings, and training.
Requirements:
  • Registered Nurse (RN) license (required).
  • Experience with claims analysis, medical records review, and compliance investigations.
  • Knowledge of MA regulations, medical billing, and fraud detection.
  • Proficiency in Microsoft Office
  • Strong written and verbal communication skills for reporting and testimony.
  • Ability to work independently, maintain confidentiality, and manage case files efficiently.
  • Must be able to travel to Harrisburg, PA for training
Preferred Qualifications:
  • Experience with Managed Care Organizations (MCOs) and HCBS providers.
  • Familiarity with PROMISe claims systems and Fraud Abuse Detection Systems (FADS).
  • Prior experience in legal proceedings, hearings, or administrative compliance

This is an opportunity to play a critical role in ensuring healthcare integrity and protecting public funds. Apply today to join our team!

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