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Remote Rn Insurance Jobs in Gilbert, AZ (NOW HIRING)

Sedgwick

RN Field Case Manager

Phoenix, AZ · On-site +1

$77.40K - $98.30K/yr

... Services & Insurance RN Field Case Manager This Field Case Manager will cover our Phoenix, AZ ... remote work environment that allows face to face interaction with injured workers and medical ...

York Risk Services

RN Field Case Manager

Phoenix, AZ · On-site +1

$77.40K - $98.30K/yr

... Services & Insurance RN Field Case Manager This Field Case Manager will cover our Phoenix, AZ ... remote work environment that allows face to face interaction with injured workers and medical ...

TEEMA Group

Clinical Quality Review Nurse

Phoenix, AZ · Remote

$41 - $44/hr

CLINICAL QUALITY REVIEWER (RN or LCSW) Location: USA- Remote in approved states Overview: TEEMA is partnering with a leading organization supporting a large-scale federal healthcare program to ...

DataAnnotation

RN

Tempe, AZ · Remote

$40 - $60/hr

MDs, PAs, and Nurses. Benefits ... This a full-time or part-time REMOTE position * You'll be able to choose which projects you want to ...

DataAnnotation

RN

Scottsdale, AZ · Remote

$40 - $60/hr

MDs, PAs, and Nurses. Benefits ... This a full-time or part-time REMOTE position * You'll be able to choose which projects you want to ...

DataAnnotation

Registered Nurse

Mesa, AZ · Remote

$40 - $60/hr

MDs, PAs, and Nurses. Benefits ... This a full-time or part-time REMOTE position * You'll be able to choose which projects you want to ...

DataAnnotation

RN

Goodyear, AZ · Remote

$40 - $60/hr

MDs, PAs, and Nurses. Benefits ... This a full-time or part-time REMOTE position * You'll be able to choose which projects you want to ...

DataAnnotation

RN

Glendale, AZ · Remote

$40 - $60/hr

MDs, PAs, and Nurses. Benefits ... This a full-time or part-time REMOTE position * You'll be able to choose which projects you want to ...

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$42

$71

How much do remote rn insurance jobs pay per hour?

As of May 30, 2026, the average hourly pay for remote rn insurance in Gilbert, AZ is $42.11, according to ZipRecruiter salary data. Most workers in this role earn between $31.39 and $49.86 per hour, depending on experience, location, and employer.

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

To thrive as a Remote RN Insurance Nurse, you need an active RN license, a strong grasp of clinical practice, and experience in case management or utilization review. Familiarity with claims processing systems, telehealth platforms, and knowledge of medical coding (ICD-10, CPT) are typically required, along with certifications like CCM or URAC being advantageous. Exceptional communication, critical thinking, and time management skills help you collaborate with patients, providers, and insurance teams effectively. These competencies ensure accurate assessments, efficient case handling, and high-quality service in a remote, compliance-driven environment.

What are some common challenges faced by Remote RN Insurance professionals, and how can they be managed effectively?

Remote RN Insurance professionals often encounter challenges such as managing a high volume of case reviews, maintaining clear communication with both patients and insurance teams, and staying updated with changing insurance policies and regulations. To manage these challenges, it’s important to develop strong organizational skills, utilize effective digital communication tools, and participate in ongoing training. Engaging with a supportive team and seeking mentorship within the organization can also help in adapting to the remote environment and ensuring quality outcomes.

What is a Remote RN Insurance nurse?

A Remote RN Insurance nurse is a registered nurse who works with insurance companies to review medical claims, assess patient care needs, and help determine the medical necessity of treatments—often from a home office. Their responsibilities may include case management, utilization review, and providing telephonic support to patients or healthcare providers. This role requires strong clinical experience, excellent communication skills, and the ability to analyze medical records and insurance policies. Working remotely, these nurses help ensure patients receive appropriate care while also managing healthcare costs for insurance providers.

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

AspectRemote Rn InsuranceRemote Rn Case Manager
CertificationsRN license, insurance knowledgeRN license, case management certification
Work EnvironmentInsurance companies, telehealthHealthcare facilities, telehealth
Employer & IndustryInsurance providers, telehealth companiesHospitals, insurance companies, healthcare agencies

Remote Rn Insurance focuses on assessing insurance claims and policy coverage, while Remote Rn Case Managers coordinate patient care plans. Both roles require RN licensure and involve telehealth work, but their primary responsibilities and employer settings differ.

What are popular job titles related to Remote Rn Insurance jobs in Gilbert, AZ? For Remote Rn Insurance jobs in Gilbert, AZ, the most frequently searched job titles are:
What job categories do people searching Remote Rn Insurance jobs in Gilbert, AZ look for? The top searched job categories for Remote Rn Insurance jobs in Gilbert, AZ are:
What cities near Gilbert, AZ are hiring for Remote Rn Insurance jobs? Cities near Gilbert, AZ with the most Remote Rn Insurance job openings:
Remote Rn Insurance jobs near you
Infographic showing various Remote Rn Insurance job openings in Gilbert, AZ as of May 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $87,587 per year, or $42.1 per hour.
Registered Nurse - Medical Policy Development/Research Specialist - Remote - AZ

Registered Nurse - Medical Policy Development/Research Specialist - Remote - AZ

Blue Cross Blue Shield of Arizona

Phoenix, AZ • On-site, Remote

Full-time

Posted yesterday

Blue Cross Blue Shield Of Arizona rating

6.0

Company rating: 6.0 out of 10

Based on 9 frontline employees who took The Breakroom Quiz

240th of 259 rated insurance

Job description

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.
At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements:
  • Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week
  • Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week
  • Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per month
  • Onsite: daily onsite requirement based on the essential functions of the job
  • Remote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building

Please note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week.
This remote work opportunity requires residency, and work to be performed, within the State of Arizona.
PURPOSE OF THE JOB
  • Perform medical technology research to support the Medical Director Staff and Medical Policy Panel with decisions to ensure that medical policies are consistent with the standards of accepted medical practice in the community.

QUALIFICATIONS
REQUIRED QUALIFICATIONS
Required Work Experience
  • 2 year(s) of experience in clinical field of practice, health insurance, or other health care related field (All Levels)
  • 1 year(s) of experience in medical policy and technology research field (Applies to Level 2)
  • 2 year(s) of experience in medical policy and technology research field (Applies to Level 3)

Required Education
  • Associate's Degree in general field of study or Post High School Nursing Diploma or Certification (LPN only) from an approved program (Applies to All Levels)

Required Licenses
  • Active, current, and unrestricted license to practice in the State of Arizona (a state in the United States) as a health professional, including RN, LPN, LPT, LBSW, LMSW, or LCSW. (Applies to All Levels)

Required Certifications
  • N/A

PREFERRED QUALIFICATIONS
Preferred Work Experience
  • 3 year(s) of experience in clinical field of practice, health insurance, or other health care related field (All Levels)
  • 1 year(s) of experience in claims retrospective review, utilization management, case management, appeals and grievances or quality review field (Applies to All Levels)
Preferred Education
  • Bachelor's Degree in Nursing or related field of study (Applies to All Levels)
Preferred Licenses
  • Active, current, and unrestricted State of Arizona (a state in the United States) license to practice as a Registered Nurse (Applies to All Levels)
Preferred Certifications
  • N/A

ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES
Level 1
  • Perform medical technology research related to coverage guidelines and new technology and provide evaluation and summarization to Medical Director Staff and/or Medical Policy Panel
  • Perform medical technology research as requested by other areas of BCBSAZ thru the Medical Policy Referral Form
  • Develop and revise coverage guidelines and criteria as requested by management, Medical Director staff or Medical Policy Panel
  • Communicate medical policy information in protocol format to all areas of BCBSAZ requiring this information
  • Participate as a contributing member on the Medical Policy Panel providing medical policy issues for discussion and, as required, on the Clinical Coding Governance Committee (CCGC).
  • Maintain a thorough knowledge of all BCBSAZ medical coverage guidelines and other policies, such as BCBS Association Medical Policy Reference Manual, MCG care guidelines and/or Change Healthcare InterQual, and eviCore criteria.
  • From the direction of management, Medical Director staff or Medical Policy Panel, facilitate external consultant reviews concerning a coverage guideline or new technology. Responsible for initiating the consultation and providing a summarization concerning the external review to the requestor. Responsible for arrangements for appropriate reimbursement for the consultant's review.
  • Communicate medical policy information in protocol format to healthcare providers upon request
  • With moderate assistance and review by management, perform basic level of code review
  • Meet quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines and required by State, Federal and other accrediting organizations
  • Maintain all standards in consideration of State, Federal, BCBSAZ and other accreditation requirements

Level 2
  • Working independently, recognizes necessity of an external consultant review concerning a coverage guideline or new technology, summarizing and reporting this information to management to facilitate the process as outlined for Level II
  • With review by management, independently perform intermediate code review with knowledge and understanding of coverage guideline development/revisions with recommendations to the Clinical Coding Governance Committee (CCGC) for integration into benefit programming
  • Responsible for the training, development and support of grade level I staff under an established training program

Level 3
  • With review by management, independently perform advanced code review with advanced knowledge and understanding of coverage guideline development/revisions with recommendations to the Clinical Coding Governance Committee (CCGC) for integration into benefit programming.
  • Working independently, initiate research from resource materials, e.g., clinical journals, periodicals, CMS (Medicare) guidelines and publications, BCBSA publications, other BCBS plans, and internet resources relating to technical, clinical and coverage guidelines, summarizing and reporting this information to management for further action
  • Responsible for the training, development and support of grade level I and II staff under an established training program

LEVEL 4
  • Assist manager with the implementation of daily operations with regard to guideline development and revisions, staff supervision, as well as necessary coaching to help each staff member reach personal, professional and department goals
  • Assist manager with the coordination of all aspects of the Medical Policy Panel and Medical Director Meeting, including preparation, agenda and minutes.
  • Assist manager with the completion of the monthly, quarterly and annual reporting to Director
  • Assist manager with the coordination of all aspects of the annual review(s) of MCG, eviCore and/or Change Healthcare InterQual criteria updates
  • Assist manager with providing oversight to responsible staff for the monthly review of BCBS Association Medical Policy and Reference Manual (MPRM) updates
  • Assist manager with providing the initial training and instruction for both professional and technical staff and designating the oversight of staff regarding training of new staff at the desk level of instruction/training
  • Responsible for the training, development and support of grade level III staff under an established training program
  • Conduct, and/or participate in internal committees that further the goals of BCBSAZ, the Health Services Division and the Medical Policy & Technology Department
  • Working independently, perform advanced code review with advanced knowledge and understanding of coverage guideline development/revisions with recommendations to the Clinical Coding Governance Committee (CCGC) for integration into benefit programming

ALL LEVELS
  • Each progressive level includes the ability to perform the essential functions of any lower levels.
  • The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.
  • Perform all other duties as assigned.

COMPETENCIES
REQUIRED COMPETENCIES
Required Job Skills
  • Intermediate PC proficiency
  • Intermediate Adobe PDF Standard proficiency
  • Intermediate word processing, spreadsheet and presentation software proficiency (Applies to All Levels)

Required Professional Competencies
  • Maintain confidentiality and privacy
  • Advanced clinical knowledge
  • Practice interpersonal and active listening skills to achieve customer satisfaction
  • Compose a variety of business correspondence
  • Follow and accept instruction and direction
  • Establish and maintain working relationships in a collaborative team environment
  • Organizational skills with the ability to prioritize tasks and work with multiple priorities
  • Independent and sound judgment with good problem solving skills (Applies to All Levels)

Required Leadership Experience and Competencies
  • N/A

PREFERRED COMPETENCIES
Preferred Job Skills
  • Advanced PC proficiency
  • Advanced Adobe PDF Standard proficiency
  • Advanced processing, spreadsheet and presentation software proficiency (Applies to All Levels)

Preferred Professional Competencies
  • N/A

Preferred Leadership Experience and Competencies
  • Participate in strategic planning
  • Resolve conflicts
  • Represent BCBSAZ in the community (Applies to All Levels)

Our Commitment
AZ Blue does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.
Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. If interested in this position, please apply.

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