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Remote Rn Insurance Assessment Jobs in Orange, CA

Zócalo Health

RN Case Manager

Los Angeles, CA · Remote

$85K/yr

RN Case Manager Remote (Full Time) Compensation: $85,000 About Us Zócalo Health is a tech-enabled ... Conduct comprehensive clinical assessments and identify medical, behavioral, and social barriers to ...

Molina Healthcare

Care Manager (RN) Remote

Long Beach, CA · On-site +1

$23.76 - $51.49/hr

Essential Job Duties • Completes comprehensive assessments of members per regulated timelines and ... auto insurance for job related travel requirements, unless otherwise required by law. • ...

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All JobsRn Insurance Assessment JobsRemote Rn Insurance Assessment JobsRemote Rn Insurance Assessment Jobs in Orange, CA

Remote Rn Insurance Assessment information

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$14

$39

$73

How much do remote rn insurance assessment jobs pay per hour?

As of Jul 15, 2026, the average hourly pay for remote rn insurance assessment in Orange, CA is $39.57, according to ZipRecruiter salary data. Most workers in this role earn between $30.25 and $43.91 per hour, depending on experience, location, and employer.

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 cities near Orange, CA are hiring for Remote Rn Insurance Assessment jobs? Cities near Orange, CA with the most Remote Rn Insurance Assessment job openings:
Remote Rn Insurance Assessment jobs near you
Infographic showing various Remote Rn Insurance Assessment job openings in Orange, CA as of July 2026, with employment types broken down into 74% Full Time, 13% Part Time, and 13% Contract. Highlights an 87% In-person, and 13% Remote job distribution, with an average salary of $82,296 per year, or $39.6 per hour.
Care Review Clinician (RN) Remote

Care Review Clinician (RN) Remote

Molina Healthcare

Long Beach, CA • On-site, Remote

$26.41 - $51.49/hr

Full-time

Posted 13 days ago

Molina Healthcare rating

8.1

Company rating: 8.1 out of 10

Based on 193 frontline employees who took The Breakroom Quiz

134th of 281 rated insurance

Job description


JOB DESCRIPTION
This RN will act as a Care Review Clinician supporting our Medicaid members who have recently been admitted to this hospital. The Medicaid will support them to ensure a successful transition from inpatient to discharge to either a nursing facility or back to their home. The position is a combination of phone call outreach and in person meetings with the members while still inpatient. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members on the phone, and enter accurate contact notes.
This is a telephonic remote position and productivity is important. Preferred candidates will have previous utilization management, case management, managed care, or inpatient hospital experience. Experience in a behavioral health setting would be a plus.
Schedule: Monday through Friday 8:00AM to 5:00PM EST 8 hours (Weekends, no nights, no call.)
Job Summary
Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
• Assesses services for members to ensure optimum outcomes, cost-effectiveness and compliance with all state/federal regulations and guidelines.
• Analyzes clinical service requests from members or providers against evidence based clinical guidelines.
• Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures.
• Conducts reviews to determine prior authorization/financial responsibility for Molina and its members.
• Processes requests within required timelines.
• Refers appropriate cases to medical directors (MDs) and presents them in a consistent and efficient manner.
• Requests additional information from members or providers as needed.
• Makes appropriate referrals to other clinical programs.
• Collaborates with multidisciplinary teams to promote the Molina care model.
• Adheres to utilization management (UM) policies and procedures.
Required Qualifications
• At least 2 years experience, including experience in hospital acute care, inpatient review, prior authorization, managed care, or equivalent combination of relevant education and experience.
• Registered Nurse (RN). License must be active and unrestricted in state of practice.
• Ability to prioritize and manage multiple deadlines.
• Excellent organizational, problem-solving and critical-thinking skills.
• Strong written and verbal communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
• Certified Professional in Healthcare Management (CPHM).
• Recent hospital experience in an intensive care unit (ICU) or emergency room.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

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About Molina Healthcare

Sourced by ZipRecruiter

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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