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Remote Insurance Nurse Jobs in Michigan (NOW HIRING)

Sedgwick

RN Field Case Manager

Grand Rapids, MI · On-site +1

$74K - $95K/yr

... Insurance RN Field Case Manager This Field Case Manager will cover our Grand Rapids, MI region and ... remote work environment that allows face to face interaction with injured workers and medical ...

York Risk Services

RN Field Case Manager

Grand Rapids, MI · On-site +1

$74K - $95K/yr

... Insurance RN Field Case Manager This Field Case Manager will cover our Grand Rapids, MI region and ... remote work environment that allows face to face interaction with injured workers and medical ...

Centene

Senior Care Manager (RN)

Macomb, MI · On-site +1

$75K - $135K/yr

... pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

Centene

Senior Care Manager (RN)

Detroit, MI · On-site +1

$75K - $135K/yr

... pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

POCKET NURSE

Account Manager

Farmington Hills, MI · On-site +1

Paid time off, personal time, paid holidays, and hybrid onsite/remote work schedule. * Company-paid life insurance. * Voluntary life, disability, accident, and critical illness insurance options.

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All JobsInsurance Nurse JobsRemote Insurance Nurse JobsRemote Insurance Nurse Jobs in Michigan

Remote Insurance Nurse information

See Michigan salary details

$20.5K

$51.5K

$85K

How much do remote insurance nurse jobs pay per year?

As of Aug 13, 2026, the average yearly pay for remote insurance nurse in Michigan is $51,506.00, according to ZipRecruiter salary data. Most workers in this role earn between $35,300.00 and $67,500.00 per year, depending on experience, location, and employer.

What are the typical daily tasks and workflow for a remote insurance nurse?

As a Remote Insurance Nurse, your daily tasks often include reviewing and evaluating medical records for insurance claims, conducting telephonic patient interviews, and collaborating with physicians or underwriters to clarify medical information. You'll use digital platforms to document your findings, communicate with clients or policyholders, and submit detailed reports for claims processing or case management. Most remote insurance nurses work independently but interact regularly with a team via virtual meetings and secure messaging. This structure offers flexibility and autonomy, while also requiring diligence and steady communication to ensure accuracy and regulatory compliance.

What is a remote insurance nurse?

A Remote Insurance Nurse is a licensed nurse who works for an insurance company to assess medical claims, review patient records, and ensure proper care management—all from a remote setting. They may conduct telephonic assessments, verify medical necessity for treatments, or assist with case management. This role helps insurers make informed decisions about coverage, care coordination, and cost efficiency. Strong clinical knowledge, attention to detail, and communication skills are essential for success in this position.

What are the key skills and qualifications needed to thrive in the remote insurance nurse position, and why are they important?

To excel as a Remote Insurance Nurse, you must have a valid RN license, thorough clinical experience, and strong knowledge of medical terminology and insurance procedures. Familiarity with health information management systems, telehealth platforms, and secure digital communication tools is important, as well as certifications like CCM (Certified Case Manager) if required. Outstanding critical thinking, attention to detail, and interpersonal communication skills are essential for evaluating claims and guiding clients through insurance processes. These competencies ensure accurate assessments, effective client support, and compliance with regulatory standards while working independently from a remote setting.

What are the most commonly searched types of Insurance Nurse jobs in Michigan? The most popular types of Insurance Nurse jobs in Michigan are:
What are popular job titles related to Remote Insurance Nurse jobs in Michigan? For Remote Insurance Nurse jobs in Michigan, the most frequently searched job titles are:
What job categories do people searching Remote Insurance Nurse jobs in Michigan look for? The top searched job categories for Remote Insurance Nurse jobs in Michigan are:
What cities in Michigan are hiring for Remote Insurance Nurse jobs? Cities in Michigan with the most Remote Insurance Nurse job openings:
Remote Insurance Nurse jobs near you
Infographic showing various Remote Insurance Nurse job openings in Michigan as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $51,506 per year, or $24.8 per hour.

Auditor, Healthcare Services (Remote in MI)

Molina Healthcare

Detroit, MI • Remote

Full-time

Posted 22 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 199 frontline employees who took The Breakroom Quiz

163rd of 306 rated insurance

Job description

JOB DESCRIPTION 

This position will offer remote work flexibility, but the selected candidate must reside in Michigan. 

Opportunity for an RN who has a US license in good standing to join our Medicaid Team as a Clinical Auditor.  The person filling this role will be an instrumental part of the team work to align the Medicaid Team compliance guidelines with those followed by our corporate teams.  Knowledge and experience working with Waiver Program is vital to success in this role. 

The preferred candidate will have 3 - 5 years of experience in a MCO and at least 2 years of clinical auditing and/or review experience. Mastery of Microsoft Office, especially Excel, PowerPoint will also be skill sets we are seeking.  Licensure should be an LPC, RN, LLMSW, LMSW, LBSW.

Hours are Monday - Friday, 8:30AM - 5PM EST. 

Job Summary

Provides support for healthcare services clinical auditing activities. Performs audits for clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide quality and cost-effective member care. 

Essential Job Duties


Performs audits in utilization management, care management, member assessment, behavioral health, and/or other clinical teams, and monitors clinical staff for compliance with National Committee for Quality Assurance, Centers for Medicare and Medicaid Services (CMS), and state/federal guidelines and requirements. May also perform non-clinical system and process audits as needed. 
Audits for clinical gaps in care from a medical and/or behavioral health perspective to ensure member needs are being met. 
Assesses clinical staff regarding appropriate clinical decision-making. 
Reports monthly outcomes, identifies areas of re-training for staff, and communicates findings to leadership. 
Ensures auditing approaches follow a Molina standard in approach and tool use. 
Maintains member/provider confidentiality in compliance with the Health Insurance Portability and Accountability Act (HIPAA), and professionalism in all communications. 
Adheres to departmental standards, policies and protocols. 
Maintains detailed records of auditing results. 
Assists healthcare services training team with developing training materials or job aids as needed to address findings in audit results. 
Meets minimum production standards related to clinical auditing. 
May conduct staff trainings as needed.  Communicates with quality and/or healthcare services leadership regarding issues identified, and works collaboratively to subsequently resolve/correct. 

Required Qualifications

At least 2 years health care experience, with at least 1 year experience in utilization management, care management, and/or managed care, or equivalent combination of relevant education and experience.

Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.

Strong attention to detail and organizational skills.

Strong analytical and problem-solving skills.

Ability to work in a cross-functional, professional environment.

Ability to work on a team and independently. Excellent verbal and written communication skills.

Microsoft Office suite/applicable software program(s) proficiency.

Preferred Qualifications


Utilization management, care management, behavioral health and/or long-term services and supports (LTSS) clinical review/auditing experience.
 

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. 
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

What Molina Healthcare employees say

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About Molina Healthcare

Sourced by ZipRecruiter

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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