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Remote Rn Case Review 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 ...

The CKHobbie Group

$42 - $47/hr

This is a remote position. We are seeking a passionate and experienced HSS Clinical Coordinator RN ... Serve as a high-risk case manager for Medicaid maternity members * Deliver care coordination ...

Sedgwick

RN Field Case Manager

Philadelphia, PA · On-site +1

$78K - $99K/yr

... RN Field Case Manager This Field Case Manager will cover Philadelphia, Pennsylvania, and ... remote work environment that allows face to face interaction with injured workers and medical ...

York Risk Services

RN Field Case Manager

Philadelphia, PA · On-site +1

$78K - $99K/yr

... RN Field Case Manager This Field Case Manager will cover Philadelphia, Pennsylvania, and ... remote work environment that allows face to face interaction with injured workers and medical ...

The CKHobbie Group

This is a remote position. Seeking a detail-oriented and highly analytical Registered Nurse (RN) to ... In this role, you will be responsible for reviewing and abstracting clinical data from medical ...

Novacore

Medical Review Nurse

Conshohocken, PA · Remote

The Medical Review Nurse is a registered nurse who can assist Novacore's Claim and Underwriting ... Ability to work independently in a remote setting. * Ability to work with multiple offices and ...

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Remote Rn Case Review information

What is the difference between Remote Rn Case Review vs Remote Rn Utilization Review?

AspectRemote Rn Case ReviewRemote Rn Utilization Review
CredentialsRegistered Nurse (RN), licensure, case review certificationsRegistered Nurse (RN), licensure, utilization review certifications
Work EnvironmentRemote, healthcare settings, insurance companiesRemote, healthcare settings, insurance companies
Employer & IndustryHospitals, insurance firms, healthcare providersInsurance companies, healthcare management organizations

Remote Rn Case Review and Remote Rn Utilization Review roles both involve remote nursing work within the healthcare and insurance industries. While they share similar credentials and work environments, case review focuses on evaluating individual patient cases, whereas utilization review assesses the necessity and appropriateness of healthcare services. Understanding these distinctions helps job seekers identify the right role based on their skills and career goals.

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What are popular job titles related to Remote Rn Case Review jobs in Pennsylvania? For Remote Rn Case Review jobs in Pennsylvania, the most frequently searched job titles are:
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What cities in Pennsylvania are hiring for Remote Rn Case Review jobs? Cities in Pennsylvania with the most Remote Rn Case Review job openings:
Remote Rn Case Review jobs near you

Fully Remote Registered Nurse (RN) Care Manager

The CKHobbie Group

Philadelphia, PA • On-site, Remote

Full-time

Posted 17 days ago

Job description


Seeking a compassionate and driven Registered Nurse (RN) Care Manager to join our team in a role designed for nurses who are ready to expand their impact beyond the traditional clinical setting. This position offers the opportunity to work closely with individuals who have complex medical, behavioral, and social needs, helping them navigate the healthcare system while improving their overall well-being. As an RN Care Manager, you will play a vital role in delivering holistic, patient-centered care that addresses not only physical health, but also the underlying factors that influence long-term outcomes.
In this role, you will engage members both over the phone and through occasional in-person visits in community or hospital settings. You will conduct comprehensive assessments that evaluate medical, behavioral, functional, and social determinants of health, and use this information to develop individualized care plans that align with each member's unique needs, goals, and preferences. By applying active listening and motivational interviewing techniques, you will help members better understand their health conditions, identify personal goals, and take meaningful steps toward positive behavior change.
The RN Care Manager serves as both an advocate and an educator, guiding members through complex healthcare decisions and ensuring they have access to the right resources at the right time. You will help members overcome barriers to care by identifying challenges, offering practical solutions, and connecting them with appropriate community-based services. In cases where urgent or high-risk situations arise, you will use your clinical judgment to escalate concerns appropriately and ensure members receive timely interventions.
Collaboration is a key component of this position. You will work alongside an interdisciplinary care team, presenting complex cases and contributing valuable clinical insight to support care planning and decision-making. Simultaneously, you will operate with a high level of autonomy, managing your own caseload in a structured virtual environment while meeting established performance goals. This balance of independence and collaboration allows you to fully utilize your clinical expertise while continuing to grow professionally.
This role is well-suited for nurses who are passionate about making a meaningful difference in patients' lives and who are seeking a more flexible and strategic approach to care delivery. It offers the opportunity to build strong, lasting relationships with members, develop expertise in case management and population health, and play a direct role in improving healthcare outcomes on a broader scale. Candidates must hold an active, unrestricted RN license in Pennsylvania, have either an associate's or bachelor's degree in nursing, and reside in the Philadelphia region. A strong passion for working with complex populations, along with the ability to work independently in a home-based setting with occasional travel, is essential.
Preferred candidates will have prior experience in case management, care coordination, or managed care environments, particularly with high-risk or medically complex populations. Additional qualifications such as a Certified Case Manager (CCM) credential, experience with utilization review or risk management, technical proficiency with Microsoft Office applications, and bilingual capabilities are considered valuable assets.

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