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Remote Rn Auditor Jobs in Michigan (NOW HIRING)

BetterHelp

Licensed Psychologist - Remote

Detroit, MI · Remote

$650/wk

Private practice with no doors and no overhead. BetterHelp is one of the world's largest online therapy platforms for mental health professionals who want to focus on client care -- not admin or

Scribe-X

Remote Medical Scribe

Lansing, MI · Remote

$14 - $17/hr

Description Become a Medical Scribe First Scribe-X offers unparalleled clinical experience and preparation for medical school. * Receive extensive paid training that will help you master EMR systems

Scribe-X

$14 - $17/hr

Description Become a Medical Scribe First Scribe-X offers unparalleled clinical experience and preparation for medical school. * Receive extensive paid training that will help you master EMR systems

Centene

Care Manager (LMSW)

Macomb, MI · On-site +1

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll

Centene

Care Manager (LMSW)

Detroit, MI · On-site +1

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll

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Remote Rn Auditor information

See Michigan salary details

$17

$28

$40

How much do remote rn auditor jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for remote rn auditor in Michigan is $28.75, according to ZipRecruiter salary data. Most workers in this role earn between $25.14 and $31.44 per hour, depending on experience, location, and employer.

What is a Remote RN Auditor?

A Remote RN Auditor is a registered nurse who reviews medical records, clinical documentation, and billing information to ensure compliance with healthcare regulations and standards—all while working remotely. Their primary focus is to verify accuracy in coding, billing, and adherence to clinical guidelines, often for insurance companies, hospitals, or healthcare organizations. They play a crucial role in identifying errors, preventing fraud, and improving the quality of patient care. This job typically requires an active RN license, strong attention to detail, and experience with healthcare compliance and auditing.

What does a Remote RN Auditor do?

As a remote RN auditor, your job is to review claims and audit financial statements to ensure validity and accuracy. In this role, you may examine documentation from the patient or clinic, evaluate the effectiveness of care, or ensure that claims comply with government regulations. RN auditors often provide advice for cutting costs and contact both healthcare providers and clients to negotiate specific claims or resolve billing issues. Remote RN auditors often work with daily or weekly batches of work as assigned, but in rare cases, you may be asked to prioritize auditing certain material when time is of the essence.

What are the key skills and qualifications needed to thrive as a Remote RN Auditor?

To thrive as a Remote RN Auditor, you need a strong background in nursing, clinical documentation, and auditing practices, typically with an active RN license and experience in medical record review. Familiarity with electronic health record (EHR) systems, coding standards (such as ICD-10 and CPT), and auditing software is essential. Attention to detail, strong analytical thinking, and effective written communication are standout soft skills in this role. These capabilities ensure accurate audits, regulatory compliance, and clear reporting in a remote healthcare environment.

What are some common challenges faced by Remote RN Auditors, and how can they be effectively managed?

Remote RN Auditors often encounter challenges such as navigating complex electronic health record systems, ensuring data accuracy while working independently, and staying updated on frequently changing compliance regulations. To manage these, successful auditors develop strong organizational skills, maintain regular communication with team members, and participate in ongoing training. Proactively seeking clarification on ambiguous cases and leveraging available resources from their organization can also help maintain high-quality audit outcomes and job satisfaction.

What is the difference between Remote Rn Auditor vs Remote Rn Reviewer?

AspectRemote Rn AuditorRemote Rn Reviewer
CertificationsRN license, auditing certifications (e.g., CHAP, RAC)RN license, clinical review certifications
Work EnvironmentHealthcare organizations, insurance companies, auditing firmsHealthcare providers, insurance companies, utilization review
Primary ResponsibilitiesAuditing medical records for compliance, coding accuracy, and billingReviewing medical records for appropriateness and medical necessity

Remote Rn Auditors focus on compliance and coding accuracy through audits, while Remote Rn Reviewers primarily assess medical necessity and appropriateness of care. Both roles require RN licensure and related certifications, often working within healthcare or insurance settings. The key difference lies in their core functions: auditing versus clinical review, though both contribute to quality and compliance in healthcare reimbursement.

How do I become a remote RN auditor?

To become a remote RN auditor, you typically need a valid registered nurse license, relevant experience in healthcare or medical record review, and knowledge of coding and compliance standards such as HIPAA. Many employers also prefer candidates with certifications like Certified Professional Medical Auditor (CPMA) or Certified Coding Specialist (CCS). Strong attention to detail and proficiency with electronic health record systems are essential for success in this role.
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Remote Rn Auditor jobs near you
Infographic showing various Remote Rn Auditor job openings in Michigan as of August 2026, with employment types broken down into 3% As Needed, 57% Full Time, 14% Part Time, 25% Contract, and 1% Nights. Highlights an 99% Physical, and 1% Remote job distribution, with an average salary of $59,806 per year, or $28.8 per hour.

Dir ICT Care Coordination PH

Amerihealth Caritas

Southfield, MI • Remote

Full-time

Re-posted 29 days ago

Key responsibilities

  • Oversee market-specific clinical programs, including Case Management, Bright Start Maternity program, and Community Outreach.

  • Direct and oversee Care Coordination - Integrated Care Team (ICT) clinical and non-clinical staff, supporting staffing, hiring, and professional development.

  • Lead performance measurement efforts, monitor care coordination quality metrics, and implement corrective actions as needed.

AmeriHealth Caritas rating

8.3

Company rating: 8.3 out of 10

Based on 73 frontline employees who took The Breakroom Quiz

134th of 315 rated insurance

Job description

Role Overview: The Director, ICT Care Coordination, is responsible for leading the strategic direction, operational execution, and performance of care coordination and population health programs within the assigned market to ensure the delivery of high-quality, compliant, and member-centered clinical and non-clinical services.

Work Arrangement:

  • Remote - Fully remote associate must be located in Michigan (MI).
  • Some travel to state and other meetings will be required

Responsibilities:

  • Partner with the Market Chief Medical Officer (CMO) and other market leaders to develop, execute, and monitor the plan's population health strategy while supporting equitable, whole-person care for members.
  • Collaborate with CMO, Quality Director, and other market leaders and evaluate continuous quality improvement and process optimization efforts across care coordination programs and initiatives
  • Oversee market-specific clinical programs, including Case Management (CM), Bright Start Maternity program, and Community Outreach
  • Ensure alignment of care coordination programs with population health strategy, enterprise policies, and contractual requirements
  • Direct and oversee Care Coordination - Integrated Care Team (ICT) clinical and non-clinical staff; support staffing, hiring, and professional development
  • Ensure compliance with state, federal, and contract requirements, including the Michigan Department of Health & Human Services (MDHHS) contract
  • Implement processes for identifying, assessing, and developing care plans for members with special healthcare needs
  • Ensure coordination of care across physical health, behavioral health, and community-based services
  • Serve as the primary point of contact with state regulatory agencies on care coordination-related activities
  • Develop and implement engagement strategies for members
  • Ensure effective coordination of services across multiple healthcare entities and providers
  • Drive integration of care coordination and disease management within population health and quality improvement initiatives
  • Lead performance measurement efforts to assess and improve health outcomes and operational effectiveness
  • Monitor transition of care programs and care coordination quality performance metrics; implement corrective actions as needed
  • Serve as liaison between market and enterprise leadership; share best practices and align strategies
  • Partner with regulatory, external quality review organizations such as (but not limited to) the National Committee for Quality Assurance (NCQA), and Quality Assessment and Performance Improvement (QAPI) teams
  • Prepare and deliver reporting, including key performance indicators (KPIs), program performance, and utilization trends
  • Support procurement activities (RFPs/RFIs) and provide subject-matter expertise for care coordination and population health expansion efforts
  • Perform other duties as assigned

Education & Experience:

  • Bachelor's degree in Nursing or other health related field with an active, unrestricted Registered Nurse (RN) licensure in MI required plus a Masters Degree or other advanced degree in nursing, social work, health services research, health policy, information technology, or other relevant field
  • 3 to 5 years of progressive management experience, including staff management, within a Medicaid managed care environment
  • 3 years of experience leading case management programs, including program design, implementation, and strategic execution
  • 3 years of experience with NCQA standards and regulatory guidelines
  • Certified Case Manager (CCM) certification required
  • Experience developing, driving, and measuring clinical operations, population health strategy, and performance improvement initiatives preferred

Licensure:

  • Active, unrestricted RN licensure in MI required.

Skills & Abilities:

  • Strong leadership and team management skills with the ability to lead multidisciplinary clinical and non-clinical teams
  • Deep understanding of population health, care coordination, and managed care operations
  • Knowledge of Medicaid regulations, state contract requirements, and compliance standards
  • Proven ability to design, implement, and optimize clinical programs and operational workflows
  • Strong analytical and performance management capabilities with a focus on outcomes and quality improvement
  • Excellent communication and collaboration skills, with the ability to engage executive leadership and external stakeholders
  • Ability to manage multiple priorities and drive execution in a complex, highly regulated environment
  • Strategic thinker with the ability to translate population health goals into actionable operational plans

  • Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint)

Employment Type: FULL_TIME

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