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Remote Rn Case Review Jobs in Virginia (NOW HIRING)

NCLEX-RN Tutor

Salem, VA · Remote

$40/hr

... NCLEX case study formats. Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates ...

... NCLEX case study formats. Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates ...

... NCLEX case study formats. Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates ...

... NCLEX case study formats. Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates ...

... NCLEX case study formats. Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates ...

... NCLEX case study formats. Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates ...

... NCLEX case study formats. Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates ...

... NCLEX case study formats. Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates ...

106444

Harrisonburg, VA · Remote

$10K/mo

Sentara Health in Harrisonburg, VA is looking to hire an Integrated Case Manager, RN. This is a remote position; however, candidates must reside in Harrisonburg and surrounding areas as travel is ...

106444

Lynchburg, VA · Remote

$10K/mo

Sentara Health in Lynchburg, VA is looking to hire an Integrated Case Manager, RN. This is a remote position; however, candidates must reside in Lynchburg and surrounding areas as travel is required.

106444

Bristol, VA · Remote

$10K/mo

Sentara Health in Bristol, VA is looking to hire an Integrated Case Manager, RN. This is a remote position; however, candidates must reside in Bristol and surrounding areas as travel is required. The ...

Leidos-QTC Medical Group is seeking a Full Time Registered Nurse to join our Occupational Health ... and review services, occupational health services, diagnostic testing, and case management ...

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Showing results 1-20

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.

What are the most commonly searched types of Rn Case Review jobs in Virginia? The most popular types of Rn Case Review jobs in Virginia are:
What cities in Virginia are hiring for Remote Rn Case Review jobs? Cities in Virginia with the most Remote Rn Case Review job openings:
LTSS Service Coordinator-RN Clinician

LTSS Service Coordinator-RN Clinician

Elevance Health

Vienna, VA • On-site, Remote

Other

Posted 19 days ago


Elevance Health rating

7.8

Company rating: 7.8 out of 10

Based on 331 frontline employees who took The Breakroom Quiz

164th of 258 rated insurance


Job description

LTSS Service Coordinator-RN Clinician

The candidate should reside in Arlington, Alexandria, Springfield, Burke, Fairfax, Annandale, Vienna, McClean, Fairfax, Leesburg, or Winchester, VA locations.

Location: This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

The LTSS Service Coordinator RN Clinician is responsible for overall management of member's case within the scope of licensure; provides supervision and direction to non-RN clinicians participating in the member's case in accordance with applicable state law and contract; develops, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of optimizing member health care across the care continuum. Responsible for performing face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, social services and long term services and supports.

How you will make an impact:

  • Identifies members for high risk complications and coordinates care in conjunction with the member and the health care team.
  • Manages members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits.
  • Obtains a thorough and accurate member history to develop an individual care plan.
  • Establishes short and long term goals in collaboration with the member, caregivers, family, natural supports, physicians; identifies members that would benefit from an alternative level of care or other waiver programs.
  • The RN has overall responsibility to develop the care plan for services for the member and ensures the member's access to those services.
  • May assist with the implementation of member care plans by facilitating authorizations/referrals for utilization of services, as appropriate, within benefits structure or through extra-contractual arrangements, as permissible.
  • Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on the development of care management treatment plans.
  • May also assist in problem solving with providers, claims or service issues.
  • Directs and/or supervises the work of any LPN/LVN, LSW, LCSW, LMSW, and other licensed professionals other than an RN, in coordinating services for the member by, for example, assigning appropriate tasks to the non-RN clinicians, verifying and interpreting member information obtained by these individuals, conducting additional assessments, as necessary, to develop, monitor, evaluate, and revise the member's care plan to meet the member's needs, and reviewing and providing input on the non-RN clinicians' performance on a regular basis.

Minimum Requirements:

  • Requires an RN and minimum of 3 years of experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role; or any combination of education and experience, which would provide an equivalent background.
  • Current, unrestricted RN license in applicable state(s) required.
  • May require state-specified certification based on state law and/or contract.

Preferred Skills, Knowledge, and Experience:

  • MA/MS in Health/Nursing preferred.
  • Travels to worksite and other locations as necessary.

Job Level: Non-Management Non-Exempt

Workshift: Job Family: MED > Licensed Nurse


What Elevance Health employees say

Pay

Benefits

Hours and flexibility

Workplace

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About Elevance Health

Sourced by ZipRecruiter

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Indianapolis, IN, US

Year founded

2004

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