RN Medical Reviewer II
Tennessee, IL ยท On-site +1
This a full-time remote position. You will work an 8-hour shift scheduled during our normal ... Active RN licensure in state hired, OR, active compact multistate RN license as defined by the ...
Tennessee, IL ยท On-site +1
This a full-time remote position. You will work an 8-hour shift scheduled during our normal ... Active RN licensure in state hired, OR, active compact multistate RN license as defined by the ...
Tennessee, IL ยท On-site +1
This a full-time remote position. You will work an 8-hour shift scheduled during our normal ... Active RN licensure in state hired, OR, active compact multistate RN license as defined by the ...
Tennessee, IL ยท On-site +1
This a full-time remote position. You will work an 8-hour shift scheduled during our normal ... Active RN licensure in state hired, OR, active compact multistate RN license as defined by the ...
Tennessee, IL ยท On-site +1
This a full-time remote position. You will work an 8-hour shift scheduled during our normal ... Active RN licensure in state hired, OR, active compact multistate RN license as defined by the ...
Tennessee, IL ยท Remote
$10/hr
Current COMPACT license to practice as an RN/ LVN/LPN held in current state of residence with no ... Ability to quickly learn new technology through video tutorials and resources in a self-led ...
Tennessee, IL ยท Remote
$10/hr
Current COMPACT license to practice as an RN/ LVN/LPN held in current state of residence with no ... Ability to quickly learn new technology through video tutorials and resources in a self-led ...
Tennessee, IL ยท Remote
$10/hr
Remote Join our mission to help transform healthcare delivery from reactive, episodic care to ... Current COMPACT license to practice as an RN/ LVN/LPN held in current state of residence with no ...
Tennessee, IL ยท Remote
$10/hr
Remote Join our mission to help transform healthcare delivery from reactive, episodic care to ... Current COMPACT license to practice as an RN/ LVN/LPN held in current state of residence with no ...
Tennessee, IL ยท On-site +1
... and will be hybrid or remote. The office is located at One Century Plaza, Nashville, TN ... Associate's degree in Nursing with an active RN license. * Required Work Experience : 5 years ...
Tennessee, IL ยท On-site +1
... and will be hybrid or remote. The office is located at One Century Plaza, Nashville, TN ... Associate's degree in Nursing with an active RN license. * Required Work Experience : 5 years ...
Tennessee, IL ยท On-site +1
Depending on business needs and individual circumstances, remote or hybrid work arrangements may be ... Active RN licensure in state hired, OR, active compact multistate RN license as defined by the ...
Tennessee, IL ยท On-site +1
Depending on business needs and individual circumstances, remote or hybrid work arrangements may be ... Active RN licensure in state hired, OR, active compact multistate RN license as defined by the ...
... registered nurses, navigators, dietitians, pharmacists, psychiatrists, social workers, and ... Paid new parent leave * Additional benefits to be detailed in offer
... registered nurses, navigators, dietitians, pharmacists, psychiatrists, social workers, and ... Paid new parent leave * Additional benefits to be detailed in offer
Inspire and develop new and existing heads within the organization * Engage and unite with ... nurses, and lab technicians-collaborates to enhance existing IT investments and improve patient ...
Inspire and develop new and existing heads within the organization * Engage and unite with ... nurses, and lab technicians-collaborates to enhance existing IT investments and improve patient ...
Inspire and develop new and existing heads within the organization * Engage and unite with ... nurses, and lab technicians-collaborates to enhance existing IT investments and improve patient ...
Inspire and develop new and existing heads within the organization * Engage and unite with ... nurses, and lab technicians-collaborates to enhance existing IT investments and improve patient ...
Burlington, IA ยท Remote
$2.4K - $10K/mo
New hires will be automatically enrolled in the company 401(k) plan at a 3% contribution rate with ... Ability to practice autonomously in a remote clinical environment, including independently ...
Burlington, IA ยท Remote
$2.4K - $10K/mo
New hires will be automatically enrolled in the company 401(k) plan at a 3% contribution rate with ... Ability to practice autonomously in a remote clinical environment, including independently ...
Fort Madison, IA ยท Remote
$2.4K - $10K/mo
New hires will be automatically enrolled in the company 401(k) plan at a 3% contribution rate with ... Ability to practice autonomously in a remote clinical environment, including independently ...
Fort Madison, IA ยท Remote
$2.4K - $10K/mo
New hires will be automatically enrolled in the company 401(k) plan at a 3% contribution rate with ... Ability to practice autonomously in a remote clinical environment, including independently ...
Muscatine, IA ยท Remote
$75K/yr
Whether you're a recent grad or simply seeking a fresh challenge, this is your chance to earn like ... Uncapped Earning Potential This is a commission-based role , and many of our new reps earn $75,000 ...
Muscatine, IA ยท Remote
$75K/yr
Whether you're a recent grad or simply seeking a fresh challenge, this is your chance to earn like ... Uncapped Earning Potential This is a commission-based role , and many of our new reps earn $75,000 ...
Nauvoo, IL ยท Remote
$75K/yr
Whether you're a recent grad or simply seeking a fresh challenge, this is your chance to earn like ... Uncapped Earning Potential This is a commission-based role , and many of our new reps earn $75,000 ...
Nauvoo, IL ยท Remote
$75K/yr
Whether you're a recent grad or simply seeking a fresh challenge, this is your chance to earn like ... Uncapped Earning Potential This is a commission-based role , and many of our new reps earn $75,000 ...
Stronghurst, IL ยท Remote
$75K/yr
Whether you're a recent grad or simply seeking a fresh challenge, this is your chance to earn like ... Uncapped Earning Potential This is a commission-based role , and many of our new reps earn $75,000 ...
Stronghurst, IL ยท Remote
$75K/yr
Whether you're a recent grad or simply seeking a fresh challenge, this is your chance to earn like ... Uncapped Earning Potential This is a commission-based role , and many of our new reps earn $75,000 ...
New Boston, IL ยท Remote
$75K/yr
Whether you're a recent grad or simply seeking a fresh challenge, this is your chance to earn like ... Uncapped Earning Potential This is a commission-based role , and many of our new reps earn $75,000 ...
New Boston, IL ยท Remote
$75K/yr
Whether you're a recent grad or simply seeking a fresh challenge, this is your chance to earn like ... Uncapped Earning Potential This is a commission-based role , and many of our new reps earn $75,000 ...
Carthage, IL ยท Remote
$75K/yr
Whether you're a recent grad or simply seeking a fresh challenge, this is your chance to earn like ... Uncapped Earning Potential This is a commission-based role , and many of our new reps earn $75,000 ...
Carthage, IL ยท Remote
$75K/yr
Whether you're a recent grad or simply seeking a fresh challenge, this is your chance to earn like ... Uncapped Earning Potential This is a commission-based role , and many of our new reps earn $75,000 ...
Kirkwood, IL ยท Remote
$75K/yr
Whether you're a recent grad or simply seeking a fresh challenge, this is your chance to earn like ... Uncapped Earning Potential This is a commission-based role , and many of our new reps earn $75,000 ...
Kirkwood, IL ยท Remote
$75K/yr
Whether you're a recent grad or simply seeking a fresh challenge, this is your chance to earn like ... Uncapped Earning Potential This is a commission-based role , and many of our new reps earn $75,000 ...
Aledo, IL ยท Remote
$75K/yr
Whether you're a recent grad or simply seeking a fresh challenge, this is your chance to earn like ... Uncapped Earning Potential This is a commission-based role , and many of our new reps earn $75,000 ...
Aledo, IL ยท Remote
$75K/yr
Whether you're a recent grad or simply seeking a fresh challenge, this is your chance to earn like ... Uncapped Earning Potential This is a commission-based role , and many of our new reps earn $75,000 ...
West Point, IA ยท Remote
$75K/yr
Whether you're a recent grad or simply seeking a fresh challenge, this is your chance to earn like ... Uncapped Earning Potential This is a commission-based role , and many of our new reps earn $75,000 ...
West Point, IA ยท Remote
$75K/yr
Whether you're a recent grad or simply seeking a fresh challenge, this is your chance to earn like ... Uncapped Earning Potential This is a commission-based role , and many of our new reps earn $75,000 ...
La Harpe, IL ยท Remote
$75K/yr
Whether you're a recent grad or simply seeking a fresh challenge, this is your chance to earn like ... Uncapped Earning Potential This is a commission-based role , and many of our new reps earn $75,000 ...
La Harpe, IL ยท Remote
$75K/yr
Whether you're a recent grad or simply seeking a fresh challenge, this is your chance to earn like ... Uncapped Earning Potential This is a commission-based role , and many of our new reps earn $75,000 ...
$22.44 - $24.06
7% of jobs
$24.06 - $25.68
16% of jobs
$25.80 is the 25th percentile. Wages below this are outliers.
$25.68 - $27.30
22% of jobs
The median wage is $27.57 / hr.
$27.30 - $28.92
26% of jobs
$29.21 is the 75th percentile. Wages above this are outliers.
$28.92 - $30.54
21% of jobs
$30.54 - $32.16
5% of jobs
$32.16 - $33.78
1% of jobs
$33.78 - $35.40
1% of jobs
$35.40 - $37.02
0% of jobs
$37.02 - $38.64
0% of jobs
$38.64 - $40.26
0% of jobs
$22
$28
$40
Remote New Grad RNs often encounter challenges such as limited in-person supervision, adapting to telehealth technologies, and building rapport with patients virtually. To address these, many organizations offer structured onboarding, mentorship, and regular remote team meetings to provide guidance and peer support. Staying proactive in communication, asking questions, and utilizing available training resources can help ease the transition from clinical settings to remote care. Embracing flexibility and continuous learning is key to thriving in this evolving and supportive work environment.
To thrive as a Remote New Grad RN, you need a valid RN license, strong foundational nursing knowledge, and excellent assessment skills. Familiarity with telehealth platforms, electronic health records (EHRs), and secure communication tools is typically required. Outstanding communication, time management, self-motivation, and the ability to work independently are vital soft skills for remote nursing roles. These skills enable safe, effective patient care and collaboration with remote healthcare teams in a virtual environment.
A Remote New Grad RN job allows newly licensed registered nurses to work from home, typically in roles such as telehealth nursing, case management, or remote patient monitoring. These positions involve providing patient education, care coordination, and support via phone or online platforms instead of in-person clinical settings. While the work is remote, most employers require strong communication skills, clinical knowledge, and possibly some prior hands-on experience.

Full-time
Medical, Dental, Vision, Life, Retirement, PTO
This job post hasย expired 1 day ago.ย Applications are no longer accepted.
Logistics: Palmetto GBA- one of BlueCross BlueShield's South Carolina subsidiary companies.
Location: This a full-time remote position. You will work an 8-hour shift scheduled during our normal business hours of 8:00 a.m.-5:00 p.m. Monday - Friday. It may be necessary, given the business need to work occasional overtime.
Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen.
What You'll Do:
Performs medical claim reviews for one or more of the following: claims for medically complex services, services that require preauthorization/predetermination, requests for appeal or reconsideration, referrals for potential fraud and/or abuse, correct coding for claims/operations.
Makes reasonable charge payment determinations based on clinical/medical information and established criteria/protocol sets or clinical guidelines.
Determines medical necessity and appropriateness and/or reasonableness and necessity for coverage and reimbursement.
Monitors process's timeliness in accordance with contractor standards.
Documents medical rationale to justify payment or denial of services and/or supplies.
Educates internal/external staff regarding medical reviews, medical terminology, coverage determinations, coding procedures, etc. in accordance with contractor guidelines.
Participates in quality control activities in support of the corporate and team-based objectives.
Provides guidance, direction, and input as needed to LPN team members.
Provides education to non-medical staff through discussions, team meetings, classroom participation, and feedback.
Assists with special projects and specialty duties/responsibilities as assigned by management.
To Qualify for This Position, You'll Need the Following:
Required Education: Associate's in a job-related field.
Degree Equivalency: Graduate of Accredited School of Nursing.
Required Work Experience: 2 years clinical experience.
Required Skills and Abilities: Working knowledge of word processing software. Ability to work independently, prioritize effectively, and make sound decisions. Good judgment skills. Demonstrated customer service and organizational skills. Demonstrated oral and written communication skills. Analytical or critical thinking skills. Ability to handle confidential or sensitive information with discretion.
Required Software and Tools: Microsoft Office.
Required Licenses and Certificates: Active RN licensure in state hired, OR, active compact multistate RN license as defined by the Nurse Licensure Compact (NLC).
Our Comprehensive Benefits Package Includes the Following:
We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment.
Subsidized health plans, dental and vision coverage
401k retirement savings plan with company match
Life Insurance
Paid Time Off (PTO)
On-site cafeterias and fitness centers in major locations
Education Assistance
Service Recognition
National discounts to movies, theaters, zoos, theme parks and more
What We Can Do for You:
We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.
What To Expect Next:
After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.
Equal Employment Opportunity Statement
BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilitiesand protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.
We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.
If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.comor call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.
We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's moreinformation.
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