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Remote Rn Case Review Jobs in Madison, WI (NOW HIRING)

CVS Health

Case Manager, Registered Nurse

Madison, WI · Remote

$54K - $155K/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 ...

CVS Health

Case Manager, Registered Nurse

Madison, WI · Remote

$54K - $155K/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 ...

WPS

Manager of Case Management and Intake

Madison, WI · On-site +1

$110K - $130K/yr

Active license as an RN in the State of Wisconsin or a valid multi-state compact license. * 7 or ... Please review Remote Worker FAQs for additional information. Benefits * Remote and hybrid work ...

Varsity Tutors

NCLEX-RN Tutor

Madison, WI · 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 ...

micro1 AI

Attorney

Madison, WI · Remote

$100 - $150/hr

Develop case strategies and motion practice templates that inform machine learning models in legal ... remote, digital-first environments. Preferred Qualifications * Law Review or Journal Editorial ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Madison, WI · On-site +1

$57.75 - $70.25/hr

Collaborate with physicians, nurses, and medical directors during case reviews. * Track, document ... Many roles offer hybrid or fully remote options. * Rewards: Competitive salary, comprehensive ...

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$47

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

As of Jun 4, 2026, the average hourly pay for remote rn case review in Madison, WI is $47.90, according to ZipRecruiter salary data. Most workers in this role earn between $35.62 and $57.88 per hour, depending on experience, location, and employer.

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 Madison, WI? The most popular types of Rn Case Review jobs in Madison, WI are:
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Remote Rn Case Review jobs near you
Telehealth RN Case Manager - Archimedes

Telehealth RN Case Manager - Archimedes

Navitus Health Solutions

Madison, WI • On-site, Remote

Other

Medical, Dental, Vision, Retirement, PTO

Posted 5 days ago

Job description


Telehealth RN Case Manager - Archimedes
Location
US-
ID
2026-6049
Category
Archimedes
Position Type
Full-Time
Remote
Yes
Company
Archimedes
About Us
Archimedes - Transforming the Specialty Drug Benefit - Archimedes is the industry leader in specialty drug management solutions. Founded with the goal of transforming the PBM industry to provide the necessary ingredients for the sustainability of the prescription drug benefit - alignment, value and transparency - Archimedes achieves superior results for clients by eliminating tightly held PBM conflicts of interest including drug spread, rebate retention and pharmacy ownership and delivering the most rigorous clinical management at the lowest net cost. .____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________. Current associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities.________We are committed to providing equal employment opportunity to all applicants and employees and comply with all applicable nondiscrimination regulations, including those related to protected veterans and individuals with disabilities. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or handicap.
Pay Range
USD $0.00 - USD $0.00 /Yr.
STAR Bonus % (At Risk Maximum)
0.00 - Ineligible
Work Schedule Description (e.g. M-F 8am to 5pm)
Monday - Friday 8 - 4:30pm
Remote Work Notification
ATTENTION: Archimedes is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.
Overview

The RN Case Manager, Telehealth (RN) will focus on improving members' health and wellness via tele-pharmacy. In addition, the RN will assist in the development and execution of additional clinical outreach program(s) to exceed client expectations.
Additional responsibilities will be the provision of telehealth coaching to members in a variety of new program offerings aimed at improving adherence and driving to the lowest net cost formulary options. Remote engagement with members and prescribers will be frequent. The RN will also support department leadership with development of appropriate clinical resources, recommendations regarding targeted medication review selections, and policies and procedures. Other support provided will include clinical oversight of pharmacy technicians, pharmacy interns, and products including reporting and audit support.

This role could be located out of our St Louis MO or Brentwood TN offices. We will consider remote associates as well.

Is this you? Find out more below!

Responsibilities

How do I make an impact on my team?

    Develop appropriate clinical algorithms, pathways and call scripts to support pharmacy staff in delivering services.
  • Review and update all algorithms and call scripts at least yearly and with updated clinical guidelines.
  • Develop documentation standards for all clinical outreach.
  • Collaborate with department staff to develop and maintain a high quality and consistent product.
  • Facilitate communication and education to clients, providers, and internal staff regarding programs and program outcomes.
  • Provide clinical outreach to members, prescribers, and pharmacy providers to enhance care coordination.
  • Stay current with new guidelines, literature, recommendations, and medications, and integrate that information into clinical programs and outreach efforts to ensure services remain up to date.
  • Maintain open lines of communication with other functional areas and departments.
  • Develop a full understanding of clients' member experience and how engagement efforts contribute to improved health and wellness.
  • Adhere to compliance and HIPAA regulations.
  • Participate in, adhere to, and support compliance, people and culture, and learning programs.
  • Perform other duties as assigned.

Qualifications

What our team expects from you?

  • Education: Associate's degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) required; BSN preferred.
  • Certification/Licenses: Current, active Registered Nurse (RN) license in good standing with the applicable State Board of Nursing is required.
  • Experience:
    • 2+ years clinical experience including direct consultation experience.
    • Experience in a clinical call center is preferred.
    • Experience as a member of a multi-disciplinary team is preferred.
    • Professional PBM industry work experience is preferred.
    • Knowledge of applicable data privacy practices and laws is preferred.
    • Knowledge of healthcare industry practices and HIPAA regulations.

What can you expect from Archimedes?

  • Top of the industry benefits for Health, Dental, and Vision insurance
  • 20 days paid time off
  • 4 weeks paid parental leave
  • 9 paid holidays
  • 401K company match of up to 5% - No vesting requirement
  • Adoption Assistance Program
  • Flexible Spending Account
  • Educational Assistance Plan and Professional Membership assistance

Location : Address
Remote
Location : Country
US

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