ZipRecruiter

Log In

2

Remote Rn Case Manager Jobs in Raleigh, NC (NOW HIRING)

Amerihealth Caritas

Quality Perform Specialist Clinical

Raleigh, NC · On-site +1

$31.25 - $41.75/hr

  • Medical

  • Retirement

  • PTO

Remote based position with a strong preference for a North Carolina resident. Will support the North Carolina plan. RN required Responsibilities: As part of the Quality Management team, the Quality ...

Amerihealth Caritas

Quality Perform Spec Clinical

Raleigh, NC · On-site +1

$31.25 - $41.75/hr

  • Medical

  • Retirement

  • PTO

Remote based position with a strong preference for a North Carolina resident. Will support the North Carolina plan. RN required Responsibilities: As part of the Quality Management team, the Quality ...

ABB

Global Mobility Specialist

Cary, NC · Remote

... point of contact and case manager for assignees and the business. You will also have the ... The work model for this role is remote (#LI-Remote), or hybrid if you are located near an ABB ...

previous page

Showing results 41-60

All JobsRn Case JobsRemote Rn Case Manager JobsRemote Rn Case Manager Jobs in Raleigh, NC

Remote Rn Case Manager information

See Raleigh, NC salary details

$18

$46

$77

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

As of Aug 19, 2026, the average hourly pay for remote rn case manager in Raleigh, NC is $46.21, according to ZipRecruiter salary data. Most workers in this role earn between $34.33 and $55.87 per hour, depending on experience, location, and employer.

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 the key skills and qualifications needed to thrive as a remote RN case manager?

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 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.

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.

Can remote RN case managers work from home?

Remote RN case managers typically work from home, utilizing electronic health records and communication tools to coordinate patient care. They often need a reliable internet connection, relevant licensure, and sometimes specific certifications, but their role allows for a flexible, home-based work environment.

What are popular job titles related to Remote Rn Case Manager jobs in Raleigh, NC?

For Remote Rn Case Manager jobs in Raleigh, NC, the most frequently searched job titles are:

What job categories do people searching Remote Rn Case Manager jobs in Raleigh, NC look for?

The top searched job categories for Remote Rn Case Manager jobs in Raleigh, NC are:

What cities near Raleigh, NC are hiring for Remote Rn Case Manager jobs?

Cities near Raleigh, NC 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 Raleigh, NC as of August 2026, with employment types broken down into 74% Full Time, 9% Part Time, and 17% Contract. Highlights an 100% Remote job distribution, with an average salary of $96,108 per year, or $46.2 per hour.

HEDIS Clinical Quality Analyst (Full Time, Remote, North Carolina Based)

Alliance

Morrisville, NC • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 4 days ago

Job description

The HEDIS Clinical Quality Analyst provides clinical direction, guidance, training, and quality oversight for all things related to the clinical aspect of Healthcare Effectiveness Data and Information Set (HEDIS). This position would oversee abstraction, overreads and quality analysis of HEDIS for both Prospective and Retrospective Seasons to ensure the company complies with the standards set by the National Committee for Quality Assurance (NCQA) and Centers for Medicare & Medicaid Services (CMS). Performs quality improvement activities to monitor/maintain quality of care and compliance with applicable standards/regulations. Performs/coordinates HEDIS data collection, medical record review, and quality improvement activities as indicated.
This position will allow the successful candidate to work a schedule that will be primarily remote. While there is no expectation of being in the office routinely, they will be required to come into the Alliance Office for business and team meetings as needed.
Responsibilities & Duties
Oversight of HEDIS Projects
  • Subject matter expert (SME) for the National Committee for Quality Assurance (NCQA) HEDIS Measures. (Hybrid, Administrative and ECDS)
  • Review the quality of HEDIS internal processes/plans for alignment with procedures and/or best practices for supporting the HEDIS Team.
  • Responsible for participating in the development, research, and implementation of HEDIS improvement activities
  • Plan implementation of Primary Source Verification (PSV) and Medical Record Review Validation (MRRV) Audits
  • Oversees quality of abstraction, quality assurance (QA) and second level QA for HEDIS Hybrid Project and Supplemental Data Audit
  • Interpret qualitative and quantitative information and appropriately document findings
  • Make recommendations for improvement related to records reviewed and report findings
  • Identify system and/or operational issues hindering the attainment of quality performance standards as defined by NCQA, applicable state and Federal laws and regulations
  • Motivate, influence, and provide direction to staff assigned to the Hybrid and SDVA projects to ensure successful completion of project goals, deliverables, and timelines
  • Analyze and interpret technical specifications, business requirements, and regulatory guidance to support accurate implementation of HEDIS measures and project activities
  • Serve as a subject matter expert on NCQA and HEDIS resources, providing guidance, training, and consultation to project teams
  • Identify and escalate situations which may pose quality, compliance, and/or safety risks that may adversely affect the HEDIS Hybrid Audit, HEDIS Prospective Audit or SDVA Audit

Coordinate/Oversees Data Analysis and Quality Intervention and Report on Findings
  • Generate monthly/weekly HEDIS Quality reports on measure performance and submit to Directors, Managers, and Supervisors
  • Coordinates and oversees all quality management programs/projects ensuring compliance with all applicable regulatory bodies
  • Develops and implements quality management and error reduction programs as needed
  • Provide written feedback to Directors, Managers and Supervisors concerning quality concerns pertaining to individual performance, compliance risks/trends, root cause analysis and any system or process improvements recommendations related to the NCQA HEDIS measures

Effectively Measure the Key Output Variables to Ensure All Performance Changes are Accurately Assessed
  • Prepare analysis of initial and repeat HEDIS measures to evaluate efficacy of interventions and to improve approach for successfully resolving the root cause as needed
  • Evaluate validity and accuracy of supplemental data sources to draw appropriate conclusions

Analyze Changes in Performance to Determine the Impacts of Interventions
  • Perform any required data analysis to evaluate gaps in care
  • Prepare comprehensive reports to ensure adequate documentation and methodology to support findings and recommendations

Evaluate Knowledge Gaps of Staff and Coordinate Training
  • Creates/Updates HEDIS measure training manuals, tip sheets, measure assessments, pocket guides for HEDIS per NCQA Technical Specifications, annually
  • Conduct HEDIS measure training/testing yearly
  • Monitor training of staff for effectiveness and impact of outcomes from enhanced training

Minimum Requirements
Education & Experience
Required:
Graduation from an accredited school of nursing with a Registered Nurse (RN) license or Licensed Practical Nurse (LPN) and five (5) years of healthcare experience in HEDIS clinical quality and process improvement.
Additional Required Experience:
Experience with the NCQA Technical Specifications and Value Set Directory.
Experience with Medical Record Abstraction/Quality Analysis and oversight of HEDIS related duties for HEDIS to include the supplemental data audit, Prospective audit and Hybrid audit. Knowledge of NCQA Health Plan HEDIS data collection and reporting requirements and processes.
Understanding of the operational requirements for data collection in support of HEDIS or similar Quality programs.
Experience with the Medicaid population related to HEDIS Measures.
Preferred:
Data analysis and IT infrastructure of standard and non-standard data related to supplemental data experience.
Certified Professional in Healthcare Quality - CPHQ preferred.
Knowledge, Skills, & Abilities
  • Knowledge of North Carolina State and Federal rules and requirements related to the service continuum in North Carolina
  • Knowledge of Tailored Plan, Integrated Care and Care Management processes and regulatory requirements
  • Knowledge of best and promising practices for behavioral & physical health and/or intellectual/developmental disabilities
  • Microsoft Excel, Word, PowerPoint, SPSS, and Survey Monkey (or other online survey tool)
  • Strong clinical skills
  • Problem solving skills
  • Interpersonal Skills
  • Strong Analytical skills
  • Problem solving and conflict resolution skills
  • Strong diplomacy skills and discretion
  • Highly effective communication skills
  • Ability to negotiate and resolve issues with minimal assistance

Salary Range
$79,425 - $101,267/Annual
Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity
An excellent fringe benefit package accompanies the salary, which includes:
  • Medical, Dental, Vision, Life, Long Term Disability
  • Generous retirement savings plan
  • Flexible work schedules including hybrid/remote options
  • Paid time off including vacation, sick leave, holiday, management leave
  • Dress flexibility

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.

Apply