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Remote Rn Insurance Jobs in Nashua, NH (NOW HIRING)

ZOLL Medical

Patient Service Representative

Manchester, NH · Remote

$17 - $21.75/hr

Preferred Candidates include (not limited to): RN, EMT, Paramedic, EMS, Firefighter, PA, LPN, MA ... Valid driver's license and car insurance and/or valid state ID * Willingness to pay a $30 annual ...

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How much do remote rn insurance jobs pay per hour?

As of Jun 11, 2026, the average hourly pay for remote rn insurance in Nashua, NH is $42.67, according to ZipRecruiter salary data. Most workers in this role earn between $31.83 and $50.48 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.
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Remote Rn Insurance jobs near you
Senior Clinical Quality Performance Specialist

Senior Clinical Quality Performance Specialist

Amerihealth Caritas

Manchester, NH • Remote

$80K - $110K/yr

Full-time

Posted 29 days ago

AmeriHealth Caritas rating

8.5

Company rating: 8.5 out of 10

Based on 69 frontline employees who took The Breakroom Quiz

87th of 260 rated insurance

Job description

Role Overview: The Senior Clinical Quality Performance Specialist is responsible for overseeing, designing, and implementing quality initiatives, identifying root causes, establishing and executing work plans to implement effective interventions. The position is grounded in data analytics skills in order to work collaboratively with providers, members, and internal departments across the organization to conduct ongoing processes that identify opportunities for quality, service, and clinical improvement. Manages activities related to plan accreditation, preventive health improvement, business analysis, and clinical and service quality improvement, including state withholds, Healthcare Effectiveness Data and Information Set (HEDIS), and Consumer Assessment of Healthcare Providers and Systems (CAHPS). Also supports the organization’s quality improvement philosophy and promotes the use of quality improvement (QI) tools in decision-making.

Work Arrangement:

  • Remote - This position is fully remote; however, the associate must be located in New Hampshire (NH).
  • Travel as needed in the NH.

Responsibilities:

  • Provide key data analysis and critical thinking for the development and assessment of quality improvement project interventions.
  • Develop reports and analyses, and present findings to the Quality Committee for input and direction.
  • Support HEDIS and Clinical Practice Guidelines.
  • Support accreditation activities and clinical quality performance improvement initiatives.
  • Perform ad-hoc analyses of underperforming processes by collaborating with Subject Matter Experts (SME) and internal stakeholders to define current processes and recommend improvements.
  • Remove barriers to ensure the successful completion of strategic quality projects.
  • Conduct analyses and provide summary reports to senior management.
  • Act as a primary liaison to internal departments requiring collaboration and coordination.
  • Support the development of new and existing staff by identifying learning and training opportunities.
  • Serve as a mentor to new hires, ensuring consistency in information and training.

Education & Experience:

  • Associate’s Degree or equivalent work experience required.
  • Registered Nurse (RN) required.
  • 5 years of experience in clinical or service quality improvement required.
  • 5 years of experience in managed care required.
  • Unrestricted Registered Nurse license in the plan’s state or any state in which the individual works.
  • Experience working within a managed care plan organization
  • Intermediate or expert level user of Microsoft Excel/SAS
  • Experience managing National Committee of Quality Assurance (NCQA) accreditation surveys preferred.
  • Knowledge and understanding of quality improvement functions within a Managed Care Organization (MCO) preferred.
  • Prior experience with project facilitation and/or project management preferred.

Skills & Abilities:

  • Proficient in Microsoft Excel or other data tools.
  • Excellent written and verbal communication skills.
  • Strong organizational, analytical, and interpersonal skills.
  • Ability to work effectively across all levels of the organization.
  • Ability to design, develop, and implement projects addressing financial, quality, and service improvements.

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