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Remote Office Rn Jobs in Pennsylvania (NOW HIRING)

Merakey

LumiLink RN

Lafayette Hill, PA · Remote

The Remote LumiLink Registered Nurse is responsible for professionally answering LumiLink calls for health-related concerns for all contracted providers. This position is responsible for the ...

MVP Recovery

PRN Remote CRNP

Chester, PA · On-site +1

$90K - $121K/yr

Flexible | PRN Position Overview MVP Recovery is seeking a Certified Registered Nurse Practitioner (CRNP) to provide follow-up medication management appointments in a PRN, primarily remote capacity.

Corry Manor

RNAC (PT) | Local Remote

Corry, PA · Remote

$29.75 - $38/hr

Overview20 hours Remote -- must reside local to Erie/Crawford County PA A RNAC coordinates the MDS ... Benefits for a MDS RN: * Promotion opportunities * Flexibility * Education/Learning * Competitive ...

Grand Rounds

Urgent Care Nurse Practitioner

Harrisburg, PA · Remote

$123K/yr

This role requires an active RN compact license and licensure in multiple states. Ideal candidates ... Remote-first culture 401(k) savings plan through Fidelity Comprehensive medical, vision, and dental ...

Sedgwick

RN Field Case Manager

Philadelphia, PA · On-site +1

$78K - $99K/yr

While frequent travel is required, you will maintain a home-based office. ARE YOU AN IDEAL ... remote work environment that allows face to face interaction with injured workers and medical ...

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Remote Office Rn information

What is the difference between Remote Office Rn vs Remote Medical Assistant?

AspectRemote Office RnRemote Medical Assistant
CredentialsRegistered Nurse (RN) licenseCertified Medical Assistant (CMA) or Medical Assistant (MA) certification
Work EnvironmentRemote administrative and clinical support for healthcare providersRemote administrative support, scheduling, and patient communication
Industry UsageHealthcare, hospitals, clinics, telehealthMedical offices, clinics, telehealth services
Common Search IntentRN remote jobs, telehealth RN rolesMedical assistant remote jobs, telehealth MA roles

The main difference is that Remote Office Rn requires an RN license and involves clinical and administrative tasks, while Remote Medical Assistant roles typically require certification and focus on administrative support within healthcare settings. Both roles support healthcare providers remotely but differ in credentials and responsibilities.

How does a Remote Office RN maintain effective communication and collaboration with physicians and other care team members while working off-site?

As a Remote Office RN, maintaining strong communication with physicians and other healthcare professionals is crucial for delivering high-quality patient care. This is typically achieved through secure electronic health record (EHR) systems, regular virtual meetings, and scheduled check-ins to discuss patient cases. Many organizations also use instant messaging platforms and collaborative software to ensure that updates and critical information are shared promptly. Building clear protocols for escalation and documentation helps facilitate seamless teamwork, even when the RN is working from a remote location.

What are Remote Office RNs?

Remote Office RNs are registered nurses who perform their duties from a non-traditional healthcare setting, often from home or a centralized office, rather than at a hospital or clinic. Their responsibilities typically involve patient education, case management, triage, care coordination, and follow-up, all conducted via telephone or digital communication platforms. This role allows nurses to leverage their clinical expertise while working remotely, supporting patients and healthcare teams virtually.

What are the key skills and qualifications needed to thrive as a Remote Office RN, and why are they important?

To thrive as a Remote Office RN, you need an active RN license, strong clinical assessment skills, and experience in telehealth or case management. Familiarity with telemedicine platforms, EHR systems, and HIPAA compliance tools is essential. Excellent communication, self-motivation, and organizational skills help you provide effective care and support to patients remotely. These abilities ensure high-quality patient outcomes, regulatory compliance, and efficient remote healthcare delivery.
What are the most commonly searched types of Office Rn jobs in Pennsylvania? The most popular types of Office Rn jobs in Pennsylvania are:
What are popular job titles related to Remote Office Rn jobs in Pennsylvania? For Remote Office Rn jobs in Pennsylvania, the most frequently searched job titles are:
What job categories do people searching Remote Office Rn jobs in Pennsylvania look for? The top searched job categories for Remote Office Rn jobs in Pennsylvania are:
What cities in Pennsylvania are hiring for Remote Office Rn jobs? Cities in Pennsylvania with the most Remote Office Rn job openings:
Remote Office Rn jobs near you

Remote/Hybrid Registered Nurse (RN) - Advocacy & Program Integrity (Medical Assistance Expert)

The CKHobbie Group

Harrisburg, PA • On-site, Remote

$40 - $42/hr

Full-time

PTO

Posted 11 days ago

Job description

Job Description
Are you a registered nurse ready to take your career in an exciting newdirection-one where your expertise truly makes a difference? JoinPennsylvania's premier Quality Improvement Organization and step into adynamic role focused on advocacy and program integrity through compliance management. Here, you'll champion the needs of vulnerable populations,safeguard the quality of care, and influence healthcare outcomes on ameaningful scale. Enjoy the freedom of working from home, theflexibility and autonomy to manage your workday, and the opportunity forcontinuous professional growth-all while being part of a passionate,mission-driven team dedicated to improving healthcare across theCommonwealth.
Are you a registered nurse ready to take your career in an excitingnew direction-one where your expertise creates real, lasting impact?Join Pennsylvania's premier Quality Improvement Organization and play a vital role in protecting healthcare quality, advocating forvulnerable populations, and ensuring the integrity of criticalhealthcare programs.
In this rewarding role, you'll use your clinical knowledge outside ofthe traditional bedside setting to review and audit claims, supportprogram integrity initiatives, and advocate for beneficiaries across theCommonwealth. You'll enjoy the flexibility of working from home, theautonomy to manage your work, and meaningful opportunities forprofessional growth-all while contributing to a mission that trulymatters.
What You'll Do
  • Conduct clinical reviews and ensure quality, appropriateness, and compliance with healthcare standards
  • Support program integrity efforts by identifying trends, risks, and opportunities for improvement
  • Advocate for beneficiaries, with a strong focus on protecting and improving care for vulnerable populations
  • Apply nursing judgment to analyze medical records, documentation, and billing data
  • Collaborate with interdisciplinary teams, providers, and stakeholders to promote best practices
  • Contribute to quality improvement initiatives that strengthen healthcare delivery across Pennsylvania

What We're Looking For
  • Active, unrestricted Registered Nurse (RN) license
  • Strong clinical background with the ability to apply nursing judgment analytically
  • Interest in advocacy, quality improvement, and healthcare program integrity
  • Excellent written and verbal communication skills
  • Ability to work independently while managing multiple priorities
  • Comfort with technology and electronic medical records

Experience in utilization review, case management, quality improvement, compliance, or claims review is a plus-but not required.
Why Join Us
  • Mission-driven work with Pennsylvania's leading Quality Improvement Organization
  • Make a real impact on healthcare quality and outcomes for vulnerable populations
  • Remote work - enjoy the convenience and balance of working from home
  • Autonomy and flexibility in how you manage your workday
  • Advocacy-focused role that values your nursing voice and expertise
  • Career development opportunities to grow beyond traditional nursing roles
  • Supportive, collaborative team culture committed to excellence and integrity

If you're a registered nurse seeking purpose-driven work,professional growth, and the flexibility to balance your life andcareer-this is your opportunity. Apply today and help shape the future of healthcare quality in Pennsylvania.
Requirements
Be available as a full-time consultant, approximately 37.5 hours per week;
• Possess a current license to practice as a Registered Nurse issued by the Pennsylvania
State Board of Nursing; or possess a non-renewable temporary practice permit issued
by the Pennsylvania State Board of Nursing. Resources possessing non-renewable
temporary practice permits must obtain licensing as a Registered Nurse within the
one-year period as defined by the Pennsylvania State Board of Nursing;
• Possess a documented work history of three (3) or more years of professional
experience with medical assistance, health care services or human services or any
equivalent combination of experience and training;
• Possess basic computer skills, including familiarity with Microsoft Office programs.
Principal Duties and Responsibilities (RN - Utilization Review / Program Integrity)
  • Conduct clinical utilization reviews by evaluating medical records, treatment plans, and supporting documentation to determine medical necessity, appropriateness, quality, and level of care in accordance with Medical Assistance (MA) program requirements.
  • Apply nursing judgment and evidence-based clinical standards to ensure MA recipients receive safe, appropriate, and high-quality care while supporting program integrity and regulatory compliance.
  • Assess provider billing and documentation to verify compliance with MA policies and identify potential fraud, waste, or abuse.
  • Review clinical documentation submitted through electronic provider portals, telephone communications, fax, and U.S. mail, ensuring completeness and accuracy for utilization determinations.
  • Make authorization determinations by approving, modifying, or denying service requests within RN scope of practice, or refer cases to physician advisors for secondary medical review when medical necessity or level of care is unclear.
  • Collaborate with physician/medical consultants to support peer-to-peer reviews and facilitate discussions with ordering providers regarding clinical justification, appropriate care settings, and service coverage.
  • Accurately document utilization review decisions and clinical rationale in electronic systems, generating authorization notices, denial letters, reason codes, and appeal rights in compliance with regulatory standards.
  • Participate in retrospective, concurrent, and prospective utilization reviews, including re-evaluations of previously denied services upon request by providers or facilities.
  • Review and prepare appeal cases by analyzing medical records, developing exhibits and correspondence, and providing testimony at administrative hearings using knowledge of MA regulations, utilization management principles, and appeal processes.
  • Interpret MA policies, regulations, and utilization management guidelines for internal staff, providers, and stakeholders through consultation, meetings, and educational sessions.
  • Engage in interdisciplinary collaboration with internal departments, medical consultants, legal staff, and external stakeholders to support consistent and defensible utilization determinations.
  • Maintain ongoing professional development through continuing education, conferences, and review of current medical literature to remain current with standards of care, clinical guidelines, and utilization review best practices.
  • Provide cross-coverage in other program areas as needed, maintaining competency through training and updates to ensure continuity of program operations.
  • Respond to inquiries from recipients, providers, legislators, legal offices, and external agencies to explain utilization decisions, coverage policies, and administrative processes.
  • Maintain accurate case records and documentation in accordance with MA regulations, accreditation standards, and organizational policies.
  • Perform related duties and special projects as assigned, with expectations and performance standards communicated for each assignment.
  • When required, work at Department-designated locations. The primary duty location is Harrisburg, PA, where appropriate workspace, technology, and resources will be provided to support assigned responsibilities.

Benefits
Attractive Compensation plan.Holiday and Vacation program.

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