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Remote Rn Insurance Jobs in Hamilton, OH (NOW HIRING)

Sedgwick

Field Case Manager - Vocational

Cincinnati, OH · On-site +1

... Insurance Field Case Manager - Vocational This Field Case Manager will cover our Dayton/Cincinnati ... LICENSING RN licensure preferred; or graduate degree in health or human services field required ...

MDS Communications

Remote Call Center Agent

Cincinnati, OH · Remote

$15 - $16/hr

We are fully registered in all 50 states and uphold the highest standards of legal and ethical ... Health insurance eligibility after just 2 months. MDS pays 75% of base employee premiums. Paid time ...

Matrix Technologies

Architect (Remote)

Cincinnati, OH · Remote

$96K - $135K/yr

State Registered Registered Architect in at least one jurisdiction with NCARB certificate * Must be ... Life Insurance Paid by Matrix and Buy-Up Options * Short-Term and Long-Term Disability Plan Paid by ...

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All JobsRn Insurance JobsRemote Rn Insurance JobsRemote Rn Insurance Jobs in Hamilton, OH

Remote Rn Insurance information

See Hamilton, OH salary details

$6

$39

$67

How much do remote rn insurance jobs pay per hour?

As of Jul 21, 2026, the average hourly pay for remote rn insurance in Hamilton, OH is $39.35, according to ZipRecruiter salary data. Most workers in this role earn between $29.33 and $46.59 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 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 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 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 are the most commonly searched types of Rn Insurance jobs in Hamilton, OH? The most popular types of Rn Insurance jobs in Hamilton, OH are:
What are popular job titles related to Remote Rn Insurance jobs in Hamilton, OH? For Remote Rn Insurance jobs in Hamilton, OH, the most frequently searched job titles are:
What job categories do people searching Remote Rn Insurance jobs in Hamilton, OH look for? The top searched job categories for Remote Rn Insurance jobs in Hamilton, OH are:
What cities near Hamilton, OH are hiring for Remote Rn Insurance jobs? Cities near Hamilton, OH with the most Remote Rn Insurance job openings:
Remote Rn Insurance jobs near you
Infographic showing various Remote Rn Insurance job openings in Hamilton, OH as of July 2026, with employment types broken down into 1% As Needed, 72% Full Time, 20% Part Time, 1% Temporary, 5% Contract, and 1% Nights. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $81,845 per year, or $39.3 per hour.
Transitional Care Manager - CKD - 2986

Transitional Care Manager - CKD - 2986

AbsoluteCare

Cincinnati, OH • On-site, Remote

Full-time

Posted 22 days ago

Job description

Job Summary
This role is a member of the integrated community care team (ICCT), providing in-person discharge planning, care coordination and integrated case management supports for members currently admitted at an inpatient facility. The transitional care manager (TCM) is assigned acute and post-acute facilities in the community. TCMs are assigned to the members at the time of admission and care coordinate for their complex medical, behavioral, and social determinants of health needs. Working in partnership with the inpatient facility and the health plan, the TCM coordinates care in collaboration with AbsoluteCare Medical Director and primary care providers, community primary care providers and specialists and local community resource and service agencies required to meet the member's individual post discharge needs. TCM effectiveness is measured by value-based care outcomes including admission and readmission rates, length of stay, bed days and hospital follow-up completion rates.
Duties and Responsibilities
  • Meet with members during their inpatient admission and develop a person-centered care plan (PCCP) to address their discharge and care transition needs.
  • Call members post discharge to review discharge instructions, complete medication reconciliation and ensure scheduling of hospital follow-up visits.
  • Coordinate member post discharge plans including hospital follow-up with primary care provider and specialists, home health, durable medical equipment, medications, social and caregiver supports.
  • Communicate with AbsoluteCare team and community primary care providers on a regular basis, review assigned member discharge plans and barriers to a safe discharge.
  • Manage PCCP and member contact in compliance with all agency requirements, internal protocols, and accreditation standards.
  • Provide education with teach back regarding medical, behavioral, and functional health conditions, symptoms, and treatment options.
  • Provide evidence-based clinical interventions centered on established person-centered care plan goals using a variety of approaches, e.g., trauma informed care, harm reduction, behavior change modalities, motivational interviewing, teach back methods and problem solving.
  • Attend clinical rounds with health plan partners, review PCCPs for discharge, provide recommendations for appropriate level of care and next steps to expedite care transitions.
  • Meet established Key Performance Indicators.
  • Manage assigned caseload based on visit and contact frequency requirements and utilization data.
  • Proactively mitigate/resolve barriers to care to increase adherence to discharge plan and reduce risk of readmission.
  • Assist members in accessing and engaging with AbsoluteCare and community services and resources and follow up on member adherence to referrals.
  • Actively participate in required meetings.
  • Other duties as assigned to meet business needs.
  • Maintain the security and privacy of all information that is owned by AbsoluteCare or maintained on behalf of the company's patients, employees, and business partners.
  • Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time.
  • This description reflects management's assignment of essential functions, it does not proscribe or restrict the tasks that may be assigned.
  • This job description is subject to change at any time.
  • This position is 80% Remote with the requirement of local travel and only manages patients with Chronic Kidney Disease

Minimum Qualifications
  • Licensed RN by the state in which practicing and abide by all laws, regulations, and requirements.
    • Preference given to RN candidates with extensive experience discharge planning, care transition coordination and medical and behavioral case management in the community. Candidate with CCM or CCTM credentials a plus.
  • 3+ years of experience in serving the needs of complex populations, including medically complex, trauma history, mental health conditions, substance abuse, and socioeconomic barriers in an office or community-based setting.
    • Preference given to qualified candidate with multiple settings experience (Inpatient, LTPAC, home health, corrections, community programs and/or human service agencies.)
    • Experience with complex government-sponsored populations preferred, e.g., Medicaid, Medicare beneficiaries.
    • Experience with member engagement, transitions of care, clinical care, and/or case management
  • Experienced in discharge planning and care coordination for continuity in care transitions, strategies for reducing readmissions and chronic condition management interventions a must.
  • Experienced in concurrent review for level of care determinations and taking action to transition to other care settings by expediting prior authorizations, leveraging the power of influence, and advocating on behalf of the member. Familiarity with MCG and ASAM criteria a plus.
  • Ability to take a creative and innovative approach to problem-solving to aid patients in overcoming barriers to care transitions.
  • Excellent computer skills including Microsoft Office Suite (Outlook, Excel, PowerPoint, Word) and electronic medical record documentation required.
  • Excellent written and oral communication skills to interact with members, families, community stakeholders, and interdisciplinary team required.
  • Ability to meet accreditation and quality standards including, but not limited to NCQA, PCMH, HEDIS through following defined procedures to assess, intervene and document interactions.
  • Ability to work independently and exercise excellent clinical judgement.
  • Active unencumbered driver's license, with automobile insurance, reliable transportation, and ability to work in office and in the community.
  • Second language ability is desirable relevant to local population, geography, resources.

Working conditions
This job operates in the community and within a professional office environment. This role requires reliable transportation to commute back and forth between inpatient facilities and office; and routinely uses general office equipment.
Physical requirements
  • Ability to communicate clearly and exchange accurate information consistently.
  • Ability to remain stationary for long periods of time.
  • Repetitious movements.
  • Constantly operates computer, keyboard, copy and fax machine, phone, and other general office equipment.
  • Ability to occasionally move objects up to 20 lbs.

Direct reports
None.
All Employees are expected to maintain the security and privacy of all information that is owned by AbsoluteCare or maintained on behalf of the company's patients, employees, and business partners. Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time. This description reflects management's assignment of essential functions, it does not proscribe or restrict the tasks that may be assigned. This job description is subject to change at any time.
Company Description:
Why Work at AbsoluteCare?
At AbsoluteCare, we serve the most vulnerable individuals in America. These are our neighbors, people who are at higher risk for disease or who have multiple, complex, chronic illnesses. Often, they deal with an unequal healthcare system and wind up seeking basic care from emergency rooms. We take these patients out of those spaces and turn them into members: people who are entitled to some of the best, most focused care this country has to offer.
We call this "care beyond medicine." We have turned the doctor's office into a comprehensive care center. Here, we surround our members with a core care team of doctors, nurses, social workers, and medical assistants who have the time and skills to get to know our members' needs. We make the most important services available to our members under one roof. This includes a pharmacy, X-rays, a blood lab, nutrition services, urgent care, and much more.
We don't stop at our four walls. We engage members in the communities where we all live to find the people who need us most. Through these community care teams, we remove the barriers to healthcare that so many people face daily. And it works.
Our unique care is guided by our core values of accountability, caring, trust, and teamwork. We call it ACT2.
AbsoluteCare, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, age, disability, genetics, protected Veteran status, or any other characteristic protected by law or policy.

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