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Remote Inova Rn Jobs in Columbia, SC (NOW HIRING)

CEI

RN/Managed Care Coordinator - Remote

Columbia, SC · Remote

Must be able to work the first 4-6 weeks onsite in Columbia, then will go remote. Must have an active, unrestricted RN License in the state of South Carolina. Must have experience in one of the ...

Amerihealth Caritas

Care Manager II

Columbia, SC · Hybrid

  • Medical

  • Retirement

  • PTO

Must hold a current and unrestricted Registered Nurse (RN) license in good standing in South Carolina. Work Arrangement:Remote; Field-Based * Regular travel required throughout assigned South ...

Ourhrconnect

Quality Medical Auditor

Columbia, SC · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

There is the potential for remote work. What You'll Do: * Determines methodology to identify cases ... Registered Records Administrator or Technician, OR, active, unrestricted RN licensure from the ...

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Remote Inova Rn information

Does Inova offer remote positions?

Inova offers some remote nursing positions, including roles for registered nurses (RNs), depending on the department and specific job requirements. These remote roles typically involve telehealth or case management and may require relevant certifications and experience. Availability of remote positions can vary based on organizational needs and current openings.

What is the best remote job for registered nurses?

A remote registered nurse (RN) can work in roles such as telehealth nurse, case manager, or health coach, which involve providing patient care, education, and support via phone or video consultations. These positions typically require active RN licensure, strong communication skills, and familiarity with electronic health records (EHR) systems. They offer flexible schedules and the ability to work from home while delivering clinical services.

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RN/Managed Care Coordinator - Remote

CEI

Columbia, SC • Remote

Full-time

Re-posted 14 days ago

Job description

Must live in the state of South Carolina.
Must be able to work the first 4-6 weeks onsite in Columbia, then will go remote.
Must have an active, unrestricted RN License in the state of South Carolina.
Must have experience in one of the following - Critical Care, ICU, ER, Cardiac PACU, Progressive Care Unit or Step-down units
M-F 8-5
Pay - 38/hr
Description -
  • Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and established clinical criteria to service requests or provides health management program interventions.
  • Utilizes clinical proficiency, claims knowledge/analysis, and comprehensive knowledge of healthcare continuum to assess, plan, implement, coordinate, monitor, and evaluate medical necessity, options, and services required to support members in managing their health, chronic illness, or acute illness.
  • Utilizes available resources to promote quality, cost effective outcomes.
  • Provides active case management, assesses service needs, develops and coordinates action plans in cooperation with members, monitors services and implements plans, to include member goals.
  • Evaluates outcomes of plans, eligibility, level of benefits, place of service, length of stay, and medical necessity regarding requested services and benefit exceptions.
  • Ensures accurate documentation of clinical information to support and determine medical necessity criteria and contract benefits. Provides telephonic support for members with chronic conditions, high risk pregnancy or other at risk conditions that consist of: intensive assessment/evaluation of condition, at risk education based on members’ identified needs, provides member-centered coaching utilizing motivational interviewing techniques in combination with reflective listening and readiness to change assessment to elicit behavior change and increase member program engagement.
  • Performs medical or behavioral review/authorization process. Ensures coverage for appropriate services within benefit and medical necessity guidelines.
  • Utilizes allocated resources to back up review determinations. Identifies and makes referrals to appropriate staff (Medical Director, Case Manager, Preventive Services, Subrogation, Quality of care Referrals, etc.).
  • Participates in data collection/input into system for clinical information flow and proper claims adjudication. Demonstrates compliance with all applicable legislation and guidelines for all regulatory bodies, which may include but is not limited to ERISA, NCQA, URAC, DOI (State), and DOL (Federal).
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