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Remote Rn Case Manager Jobs in Miami, FL (NOW HIRING)

Molina Healthcare

Trainer, Clinical Services

Miami, FL · Remote

$29.05 - $56.64/hr

Active and unrestricted Registered Nurse (RN) or licensed social worker/counselor. Certified Case Manager (CCM), Certified Professional in Health Care Quality (CPHQ), or other related certification ...

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All JobsRn Case JobsRemote Rn Case Manager JobsRemote Rn Case Manager Jobs in Miami, FL

Remote Rn Case Manager information

See Miami, FL salary details

$18

$45

$76

How much do remote rn case manager jobs pay per hour?

As of Jul 13, 2026, the average hourly pay for remote rn case manager in Miami, FL is $45.46, according to ZipRecruiter salary data. Most workers in this role earn between $33.80 and $54.95 per hour, depending on experience, location, and employer.

Do RN case managers work from home?

Yes, many RN case managers work remotely, especially in roles that involve care coordination, documentation, and communication with healthcare providers. Remote work for RN case managers often requires strong computer skills, familiarity with electronic health records, and relevant licensure, allowing for flexible schedules and home-based environments.

What is a Remote RN Case Manager?

A Remote RN Case Manager is a registered nurse who coordinates patient care, manages treatment plans, and advocates for patients—working primarily from a remote location rather than in a traditional healthcare facility. They assess patient needs, communicate with healthcare providers, and help ensure that patients receive timely and appropriate care. Remote RN Case Managers often use technology to monitor patient progress, provide education, and facilitate communication between patients and the healthcare team. This role is crucial in improving patient outcomes, reducing hospital readmissions, and supporting overall healthcare efficiency.

What are some common challenges faced by remote RN Case Managers, and how can they be addressed?

Remote RN Case Managers often encounter challenges such as maintaining effective communication with patients and interdisciplinary teams, managing caseloads across different time zones, and ensuring patient privacy during virtual interactions. To address these, it is important to leverage secure telehealth platforms, establish regular check-ins with team members, and stay organized with digital case management tools. Continuous professional development in remote communication and time management can also help RN Case Managers thrive in a virtual work environment.

How much do remote RN case managers make?

Remote RN case managers typically earn between $70,000 and $90,000 annually, depending on experience, location, and employer. They often work independently with strong clinical skills and may require licensure in their state of practice.

How can I make 2000 a week working from home?

A Remote RN Case Manager can potentially earn $2,000 or more weekly by working full-time, managing a high caseload, and possessing specialized skills or certifications. Increasing income may involve gaining experience, working overtime, or taking on additional cases, often requiring strong organizational and communication skills. Compensation varies based on employer, location, and workload, but high-volume remote case management can meet this income level for experienced professionals.

How to make 300,000 as a nurse online?

A remote RN case manager can potentially earn $300,000 annually by gaining specialized certifications, such as case management or telehealth credentials, and working for high-paying healthcare organizations or insurance companies. Increasing experience, taking on leadership roles, and working overtime or multiple contracts can also boost income in this field.

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

To thrive as a Remote RN Case Manager, you need a current RN license, strong clinical assessment skills, and experience in case management or care coordination. Familiarity with case management software, telehealth platforms, and electronic health records (EHRs) is typically required. Excellent communication, critical thinking, and self-motivation are standout soft skills for this remote role. These skills ensure effective patient support, accurate care planning, and seamless collaboration with healthcare teams from a distance.

What is the difference between Remote Rn Case Manager vs Remote Lpn Case Manager?

FeatureRemote Rn Case ManagerRemote Lpn Case Manager
CredentialsRegistered Nurse (RN) licenseLicensed Practical Nurse (LPN) license
Work EnvironmentHealthcare facilities, insurance companies, telehealthLong-term care, home health, insurance
Industry UsageWidely used in case management, patient advocacyCommon in basic patient care coordination
Job ResponsibilitiesCare planning, patient advocacy, complex case coordinationBasic patient monitoring, routine care coordination

The main difference between a Remote Rn Case Manager and a Remote Lpn Case Manager lies in their credentials and scope of practice. RNs typically handle more complex cases and have broader responsibilities, while LPNs focus on routine patient care and basic case coordination. Both roles are essential in healthcare, but RNs generally require more advanced training and licensing.

What are popular job titles related to Remote Rn Case Manager jobs in Miami, FL? For Remote Rn Case Manager jobs in Miami, FL, the most frequently searched job titles are:
What job categories do people searching Remote Rn Case Manager jobs in Miami, FL look for? The top searched job categories for Remote Rn Case Manager jobs in Miami, FL are:
What cities near Miami, FL are hiring for Remote Rn Case Manager jobs? Cities near Miami, FL with the most Remote Rn Case Manager job openings:
Remote Rn Case Manager jobs near you
Infographic showing various Remote Rn Case Manager job openings in Miami, FL as of July 2026, with employment types broken down into 74% Full Time, 13% Part Time, and 13% Contract. Highlights an 100% Remote job distribution, with an average salary of $94,562 per year, or $45.5 per hour.
Manager, Clinical Appeals

Manager, Clinical Appeals

Health Business Solutions LLC

Cooper City, FL • Remote

Full-time

Re-posted 29 days ago

Job description

Job Summary:

We are seeking an experienced and highly organized Manager of Clinical Appeals to lead our clinical appeals operations across commercial and government payers. This role is responsible for overseeing day-to-day activities of clinical appeal specialists, managing appeal strategy execution, ensuring quality and compliance, and meeting client-specific performance goals.

The ideal candidate brings a strong background in clinical review, medical necessity denials, payer appeal processes, and team leadership—ideally across both U.S. and offshore teams (e.g., Philippines). This position is critical to ensuring timely and effective resolution of denied claims, supporting revenue recovery efforts, and maintaining payer and regulatory compliance.

Key Responsibilities:

  • Manage the full-cycle clinical appeals process across multiple payer types, with a focus on government (e.g., Medicare, Medicaid) and commercial payers.
  • Lead and support a team of nurses, clinical reviewers, and appeal specialists—including potential offshore (Philippines-based) staff.
  • Monitor appeal workloads, productivity, and turnaround times to ensure all appeal deadlines and client service level agreements (SLAs) are met.
  • Review and approve complex or high-value clinical appeal cases, ensuring clinical accuracy and compliance with payer guidelines.
  • Maintain up-to-date knowledge of medical necessity criteria, payer policies, NCDs/LCDs, and applicable CMS regulations.
  • Train new and existing team members on clinical guidelines, appeal writing standards, and regulatory requirements.
  • Work cross-functionally with audit, legal, compliance, and operations teams to align on strategy and escalate trends or systemic payer issues.
  • Identify and implement process improvements to increase efficiency, reduce denials, and improve overturn rates.
  • Support the creation and refinement of appeal templates, clinical arguments, and documentation standards.
  • Generate and deliver performance and quality reports to leadership, identifying risks and opportunities for improvement.

Qualifications:

  • Registered Nurse (RN) or clinical degree required; Bachelor's degree in Nursing, Health Administration, or related field preferred.
  • 5+ years of experience in clinical appeals, utilization review, or medical necessity denials.
  • 2+ years in a leadership or supervisory role, preferably within a revenue cycle or payer appeals setting.
  • In-depth understanding of payer denial processes, especially Medicare Advantage, Medicaid Managed Care, and commercial plans.
  • Experience managing remote and/or offshore teams (Philippines experience preferred).
  • Strong working knowledge of ICD-10, CPT, and HCPCS coding as they relate to clinical justifications.
  • Excellent writing skills and the ability to clearly communicate complex clinical reasoning.
  • Familiarity with appeal submission portals, EHRs, and workflow platforms.
  • Knowledge of HIPAA, CMS, and NCQA standards.

Apply