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Remote Rn Case Review Jobs in Virginia (NOW HIRING)

Sentara Healthcare

Nurse Case Manager

Newport News, VA · On-site +1

Position is remote but does require in person face-to-face assessments multiple times throughout ... Virginia or Compact RN License (Required) Experience * 3 years experience in Nursing (Required)

Sentara Healthcare

Nurse Case Manager

Richmond, VA · On-site +1

Position is remote but does require in person face-to-face assessments multiple times throughout ... Virginia or Compact RN License (Required) Experience * 3 years experience in Nursing (Required)

Sentara Healthcare

Nurse Case Manager

Newport News, VA · On-site +1

Position is remote but does require in person face-to-face assessments multiple times throughout ... Virginia or Compact RN License (Required) Experience * 3 years experience in Nursing (Required)

CVS Health

Case Manager, Registered Nurse

Richmond, VA · Remote

$54.10K - $155.54K/yr

Position Summary This is a remote work from home role anywhere in the US with virtual training ... Perform medical necessity reviews. Required Qualifications * 5+ years' experience as a Registered ...

Akima

Nurse Case Manager

Herndon, VA · Remote

Assessing new applicants by gathering information, reviewing diagnoses and analyzing medical test ... The candidate must possess, at minimum, an active RN license and a bachelor's degree in nursing ...

Akima

Nurse Case Manager

Herndon, VA · Remote

Assessing new applicants by gathering information, reviewing diagnoses and analyzing medical test ... The candidate must possess, at minimum, an active RN license and a bachelor's degree in nursing ...

Aetna

Case Manager RN

Charlottesville, VA · Remote

Click here to review the benefits associated with this position. Aetna is an equal opportunity ... JVS Job Title Case Manager RN * POSITION SUMMARY The RN Case Manager utilizes advanced clinical ...

Sentara

RN Integrated Care Manager

Virginia Beach, VA · Remote

$10K/mo

Remote in Virginia Beach, VA Overview Responsible and accountable for the provision and ... Case Management experience 3 years preferred * Previous experience with the pediatric population ...

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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 Virginia? For Remote Rn Case Review jobs in Virginia, the most frequently searched job titles are:
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Remote Rn Case Review jobs near you
Registered Nurse (RN) - Case Manager - Virginia

Registered Nurse (RN) - Case Manager - Virginia

Adecco

Williamsburg, VA • Remote

$46.66/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 20 days ago

Job description

Registered Nurse (RN) – Case Manager

Location: Remote (Must reside in Virginia) Compensation: $46.66 per hour Licensure: Active, unrestricted Virginia RN License required

Role Overview

As a Case Manager, you will play a pivotal role in advocating for members by facilitating a collaborative process of assessment, planning, and advocacy. You will utilize clinical tools and data to identify member needs, evaluate benefit plans, and ensure cost-effective, high-quality outcomes. This is a sedentary, fast-paced role that relies heavily on clinical expertise, regulatory compliance, and digital proficiency.

Key Responsibilities

  • Comprehensive Assessments: Conduct detailed reviews of referred members' needs and eligibility using clinical tools and data.

  • Case Resolution: Determine the best approach for meeting member needs by evaluating internal/external programs and benefit plans.

  • Regulatory Compliance: Apply and interpret standardized case management plans, policies, and regulatory standards to ensure the appropriate administration of benefits.

  • Quality Management: Utilize established case management and quality processes in strict accordance with accreditation guidelines and company procedures.

  • Advocacy: Serve as a bridge between members and healthcare resources to promote optimal health outcomes.

Qualifications & Experience

  • Education/Licensure: Must be a Registered Nurse with an active, unrestricted VA license.

  • Clinical Experience: Minimum of 3 years of clinical practice (e.g., hospital, home health, or ambulatory care).

  • Industry Knowledge: Experience in healthcare and/or the managed care industry.

  • Case Management: Prior experience in Case Management is highly preferred.

  • Technical Skills: Proficiency in navigating multiple computer systems, high-speed keyboarding, and managing digital documentation.

Required Skills

  • Communication: Exceptional verbal and written communication skills for member advocacy and internal reporting.

  • Adaptability: Ability to multitask and prioritize effectively in a fast-paced, evolving environment.

  • Critical Thinking: Strong ability to interpret complex criteria and guidelines.

Physical Requirements & Environment

  • Setting: Typical office/remote environment with high productivity and quality expectations.

  • Physical Demands: This is a sedentary role requiring extended periods of sitting, talking on the phone, and typing.

  • Visual Acuity: Must be able to perform close inspections of handwritten documents, computer-generated reports, and PC monitors.

Are you ready to use your clinical expertise to make a difference in member care? Apply today.


Pay Details: $46.66 per hour
Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.
Equal Opportunity Employer/Veterans/Disabled
Military connected talent encouraged to apply
To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.adecco.com/en-us/candidate-privacy
The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:
  • The California Fair Chance Act
  • Los Angeles City Fair Chance Ordinance
  • Los Angeles County Fair Chance Ordinance for Employers
  • San Francisco Fair Chance Ordinance

Massachusetts Candidates Only: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.