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Remote Rn Insurance Assessment Jobs in Boston, MA

Crossway Homecare

Registered Nurse

North Andover, MA · Remote

$40 - $42/hr

Performs assessment visit and documents timely. (i.e. OASIS/ Skilled Nursing Note etc). * Performs physical examination and review of all body systems and documents such accordingly. * Develops an ...

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Remote Rn Insurance Assessment information

What are some common challenges faced by Remote RN Insurance Assessment nurses, and how can they overcome them?

Remote RN Insurance Assessment nurses often encounter challenges such as managing a high volume of assessments, navigating various electronic health record systems, and ensuring thorough documentation while working independently. Effective time management, strong organizational skills, and ongoing communication with team members and supervisors are essential for success. Utilizing available training resources and participating in regular team meetings can also help nurses stay updated on best practices and maintain a collaborative work environment, even while working remotely.

What are Remote RN Insurance Assessment jobs?

Remote RN Insurance Assessment jobs involve registered nurses working from home to assess patients' health status for insurance companies. These nurses review medical records, conduct telephonic or virtual health assessments, and document findings to help insurance companies make decisions on coverage, claims, or wellness programs. The role requires strong clinical knowledge, attention to detail, and excellent communication skills. It offers flexibility and the opportunity to use nursing expertise outside of traditional clinical settings.

What is the difference between Remote Rn Insurance Assessment vs Remote Rn Case Manager?

AspectRemote Rn Insurance AssessmentRemote Rn Case Manager
CredentialsRegistered Nurse (RN) license, insurance assessment certificationsRegistered Nurse (RN) license, case management certifications
Work EnvironmentRemote, primarily conducting assessments via phone or onlineRemote, coordinating patient care and services
Employer & IndustryInsurance companies, third-party administratorsHealthcare providers, insurance companies, managed care organizations

While both roles require an RN license and involve remote work, Remote Rn Insurance Assessment focuses on evaluating insurance claims and determining coverage eligibility. In contrast, Remote Rn Case Managers coordinate ongoing patient care, manage treatment plans, and liaise with healthcare providers. Understanding these differences helps professionals choose the role that best fits their skills and career goals.

What are the key skills and qualifications needed to thrive as a Remote RN Insurance Assessment Nurse, and why are they important?

To excel as a Remote RN Insurance Assessment Nurse, you need a current RN license, strong clinical assessment skills, and a thorough understanding of medical terminology and insurance protocols. Proficiency in telehealth platforms, electronic medical records (EMR), and insurance assessment tools such as MCG or InterQual is typically required. Exceptional communication, attention to detail, and the ability to work independently are crucial soft skills for this role. These competencies ensure accurate patient evaluations, effective remote collaboration, and compliance with insurance guidelines, ultimately leading to high-quality service and informed decision-making.
What are the most commonly searched types of Rn Insurance Assessment jobs in Boston, MA? The most popular types of Rn Insurance Assessment jobs in Boston, MA are:
Remote Rn Insurance Assessment jobs near you
Clinical Manager Registered Nurse - (Hybrid Remote - Massachusetts)

Clinical Manager Registered Nurse - (Hybrid Remote - Massachusetts)

Maximus

Boston, MA • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 21 days ago

Maximus rating

6.9

Company rating: 6.9 out of 10

Based on 297 frontline employees who took The Breakroom Quiz

280th of 487 rated business services

Job description

General information
Job Posting Title
Clinical Manager Registered Nurse - (Hybrid Remote - Massachusetts)
Date
Monday, July 6, 2026
City
Boston
State
MA
Country
United States
Working time
Full-time
Description & Requirements
Lead a Team. Improve Lives. Shape the Future of Community-Based Care.
Are you an experienced Registered Nurse leader who is passionate about coaching others, improving clinical quality, and making a meaningful impact in your community? Maximus is seeking a Clinical Manager (RN) to lead a team of dedicated nurse assessors supporting the Massachusetts Executive Office of Health and Human Services (EOHHS) Long-Term Services and Supports (LTSS) Program.
In this leadership role, you'll mentor and develop a team of registered nurses, provide clinical guidance on complex cases, ensure high-quality, person-centered assessments, and help drive exceptional outcomes for individuals receiving community-based services across Massachusetts. Your leadership will directly influence the quality of care delivered to some of the Commonwealth's most vulnerable populations while fostering a culture of clinical excellence, collaboration, and continuous improvement.
This role combines clinical leadership with field engagement, supporting nurses across an assigned region while traveling within state of Massachusetts as needed to complete assessment or other field related work. Eligible business travel is reimbursed at the current IRS federal mileage rate of 76.0 cents per mile. The remaining time is focused on coaching staff, reviewing clinical documentation, supporting quality initiatives, partnering with interdisciplinary teams, and helping build a high-performing nursing organization.
If you're looking for an opportunity to lead, mentor, and make a lasting impact beyond direct patient care, we'd love to hear from you.
About the Program:
The Massachusetts Executive Office of Health and Human Services (EOHHS), through the MassHealth Office of Long-Term Services and Supports (LTSS), helps individuals with disabilities and chronic conditions live safely, independently, and with dignity in their communities.
As the Public Assessor Option (PAO), Maximus conducts comprehensive clinical assessments, educates providers, and supports eligibility for Adult Day Health (ADH), Adult Foster Care (AFC), Group Adult Foster Care (GAFC), and Personal Care Attendant (PCA) services throughout the Commonwealth.
Why Nurse Leaders Choose Maximus
Lead and mentor an experienced team of Registered Nurses
Monday-Friday schedule with flexibility to manage your workday
IRS federal mileage reimbursement for eligible business travel
Performance bonus opportunity
Unlimited Time Off (UTO)
Professional development and leadership growth opportunities
Tuition reimbursement and company-paid license renewals
Comprehensive medical, dental, vision, and retirement benefits
Essential Duties and Responsibilities
- Manage clinical and nursing team in the planning, monitoring and execution of all projects within the portfolio.
- Provides direct supervision to a team of direct reports.
- Directly responsible for contract performance including financial, quality, outcomes and client satisfaction.
- Primary point of contact for client and some stakeholders to meet project needs and minimize exposure to risk.
- Contribute to division growth through work on bids and proposals, client communication and related activities.
- Work with Operations and shared services to increase quality, efficiency and cost-effectiveness.
Minimum Requirements
- RN license valid in the state of practice is required
- Bachelor's degree
- 5 year's of related experience or equivalent combination of education and experience required
- Minimum 3 years of experience in project or program management required
- Bachelor's degree in Nursing
- An active, unencumbered Registered Nurse (RN) license in the state of Massachusetts
- Residency in the state of Massachusetts is required
- Minimum of 5 years of clinical nursing experience or equivalent relevant experience
- Minimum 3 years of experience Supervising clinical staff
- Familiarity with Home and Community Based Services waivers (HCBS) and prior experience conducting clinical assessments
- Subject matter expertise in Medicaid LTSS
- Proficiency in Microsoft Office applications
Preferred Requirements
- Master's degree in Nursing
- Proficiency in Adobe applications
- Proficiency in Smartsheet
- Familiarity with the Time to Test (TTT) assessment
- Experience in utilization review or utilization management
- Prior experience working remotely
- Prior experience with data analytics, including preparation of monthly reports and collaboration with state partners
- Minimum understanding of the following:
  • Program clinical eligibility requirements for the MA EOHHS LTSS Programs (AFC/GAFC/ADH/ PCA)
  • Documentation requirements for Assessment processes, including physician and medical information forms or other TTT Tool documents;
  • Caregiver and Surrogate participation in the Assessment process;
  • Understanding of the Appeals and pre-Board of Hearing mediation process and how to complete the process, including documentation of activities
  • Use of Microsoft Office products (Outlook/ Word) and experience with inputting assessments into an electronic system

Home Office Requirements
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
- Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
- Minimum 5 Mpbs upload speeds
- Private and secure workspace
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EEO Statement
Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.
Accommodations
Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at applicantaccom@maximus.com.
Minimum Salary
$
110,000.00
Maximum Salary
$
130,000.00

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