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Remote Nurse Risk Management Jobs in Pennsylvania

Bcbsa

$150K - $200K/yr

Risk Management and Compliance. 35% * Collaborate with Finance, Legal, and IT to strengthen ... The compensation for this role is budgeted between $150,000 and $200,000. #LI-Remote This is the ...

Fresh Prints

... remote contractor. This role supports the insurance professionals by managing essential ... As a Lead Risk Advisor Assistant , you will serve as a senior support partner to one or more Risk ...

Corvel

Telephonic Case Manager I

Norristown, PA · Remote

$63K - $95K/yr

This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Provide medical case management to ... Utilize medical and nursing knowledge to discuss the current treatment plan/alternate treatment ...

Deloitte

Cyber ServiceNow - Consultant

Pittsburgh, PA · Remote

... manage cyber, risk, and technology programs. Recruiting for this role ends on 12/31/2026. Work you ... This compensation range is specific to a Remote role and takes into account the wide range of ...

Deloitte

Cyber ServiceNow - Consultant

Philadelphia, PA · Remote

... manage cyber, risk, and technology programs. Recruiting for this role ends on 12/31/2026. Work you ... This compensation range is specific to a Remote role and takes into account the wide range of ...

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All JobsNurse Risk Management JobsRemote Nurse Risk Management JobsRemote Nurse Risk Management Jobs in Pennsylvania

Remote Nurse Risk Management information

What is the difference between Remote Nurse Risk Management vs Remote Nurse Compliance Coordinator?

AspectRemote Nurse Risk ManagementRemote Nurse Compliance Coordinator
CertificationsRN license, risk management certifications (e.g., CPHRM)RN license, compliance certifications (e.g., CHC, CCEP)
Work EnvironmentHealthcare facilities, insurance companies, legal teamsHealthcare organizations, regulatory agencies, legal departments
Employer UsageFocus on patient safety, legal risk reductionFocus on regulatory adherence, policy implementation

Remote Nurse Risk Management and Remote Nurse Compliance Coordinator roles share similar credentials and work environments but differ in focus. Risk managers primarily handle patient safety and legal risk, while compliance coordinators ensure adherence to healthcare regulations and policies. Both roles are vital in healthcare settings and often overlap in responsibilities, but their core objectives distinguish them clearly.

What is a remote nurse risk management?

Remote nurse risk managers are registered nurses who work offsite, using digital tools and telecommunication to assess, monitor, and mitigate risks in healthcare settings. They review patient care processes, analyze incident reports, and collaborate with healthcare teams to ensure patient safety and regulatory compliance. By working remotely, they help identify potential risks and implement strategies to reduce errors, improve quality of care, and prevent legal or financial liabilities for healthcare organizations.

What are the key skills and qualifications needed to thrive as a remote nurse risk management professional?

To thrive as a Remote Nurse Risk Management professional, you need a strong background in clinical nursing, risk assessment, and healthcare compliance, usually supported by an active RN license and experience in risk management. Familiarity with incident reporting systems, risk analysis software, and electronic health records (EHRs) is often required, along with certifications such as CPHRM (Certified Professional in Healthcare Risk Management). Strong analytical thinking, attention to detail, and effective communication are essential soft skills for evaluating risks and collaborating with cross-functional teams. These skills are crucial to proactively identify and mitigate patient safety risks, ensure regulatory compliance, and promote quality care in a remote setting.

How does a remote nurse risk management professional typically collaborate with other healthcare professionals while working offsite?

Remote nurse risk managers regularly collaborate with physicians, case managers, and administrative staff through secure digital platforms such as video conferencing, electronic health records, and messaging systems. They often participate in virtual meetings to discuss patient safety concerns, review incident reports, and help develop protocols to mitigate risk. Effective communication and organization are essential, as remote collaboration requires proactive follow-up and clear documentation to ensure all stakeholders are aligned on risk management strategies.
What are the most commonly searched types of Nurse Risk Management jobs in Pennsylvania? The most popular types of Nurse Risk Management jobs in Pennsylvania are:
What are popular job titles related to Remote Nurse Risk Management jobs in Pennsylvania? For Remote Nurse Risk Management jobs in Pennsylvania, the most frequently searched job titles are:
What job categories do people searching Remote Nurse Risk Management jobs in Pennsylvania look for? The top searched job categories for Remote Nurse Risk Management jobs in Pennsylvania are:
What cities in Pennsylvania are hiring for Remote Nurse Risk Management jobs? Cities in Pennsylvania with the most Remote Nurse Risk Management job openings:
Remote Nurse Risk Management jobs near you
Infographic showing various Remote Nurse Risk Management job openings in Pennsylvania as of August 2026, with employment types broken down into 79% Full Time, 16% Part Time, and 5% Contract. Highlights an 100% Remote job distribution.

Director of Audit - Synergie (Remote)

Bcbsa

Remote

$150K - $200K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 8 days ago

Job description

The Director of Audit is responsible for overseeing the organization's client and pharmaceutical rebate audit function and ensuring the effectiveness of financial, operational, and contractual compliance controls across the enterprise. This role also supports organizational SOC audits. This role leads the planning and execution of audit programs, identifies risk exposures, and provides actionable recommendations to enhance operational execution, governance, efficiency, and compliance. The Director works closely with executive leadership to promote a strong internal control culture and continuous improvement mindset. In addition, this role supports participants in Synergie pharma audits.

Audit Execution. 35%

  • Lead and oversee pharma and client audits for Synergie.
  • Support SOC audit evidence gathering for annual audit.
  • Ensure audit work adheres to contractual standards and organizational policies.
  • Evaluate the efficiency and effectiveness of internal controls, processes, and risk management frameworks.
  • Coordinate with external auditors and participants to ensure alignment and minimize redundancy.
  • Communicate with participants during pharma rebate audits and obtain evidence requested.

Risk Management and Compliance. 35%

  • Collaborate with Finance, Legal, and IT to strengthen controls around invoicing.
  • Monitor corrective action plans, ensuring timely resolution of audit findings. Advise on new business processes, system implementations, and policy changes from a risk perspective.
  • Assist in development and manage invoicing and audit policies and procedure.

Leadership and Strategy. 30%

  • Develop and execute the annual risk-based audit plan aligned with organizational strategy and regulatory requirements.
  • Provide strategic direction and thought leadership for audit, risk management, and internal control programs.
  • Partner with internal leaders to identify and mitigate emerging risks within invoicing and data governance of invoicing information.
  • Present findings, insights, and progress updates to Invoicing & Audit management.

Requirements:

  • Bachelor's degree in business, healthcare, or other related field; Master's degree preferred.
  • 8+ years of work experience in a health care auditing role, with expertise in health plans, health systems, pharmacy, and managed care or specialty pharmacy. Must include at least 3 years of experience in medical and/or pharmacy drug management at a health plan or PBM.
  • Strong experience managing external audit vendors during audits
  • Strong understanding of audit practices
  • Experience designing and executing audit programs.
  • Strong data management and analytics skills with the ability to manage large data effectively.
  • Strong knowledge of medical and pharmacy rebates, value-based contracts, and invoicing processes.
  • Demonstrated ability to lead cross-functional teams, drive results in a fast-paced environment, and manage client support while ensuring alignment with Synergie's objectives.
  • Ability to develop relationships and influence with internal and external stakeholders
  • Excellent leadership, communication and critical thinking skills and ability to anticipate issues and develop solutions.
  • Must be eligible to work in the United States without need for work visa or residency sponsorship.

The compensation for this role is budgeted between $150,000 and $200,000.

#LI-Remote

This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the hiring range and this hiring range may also be modified in the future. A candidate's position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.This job is also eligible for annual bonus incentive pay.

We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.

Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

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