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Remote Rn Insurance Jobs in New Brunswick, NJ (NOW HIRING)

Mercor

Utilisation Management Expert - RN

New York, NY · Remote

$100 - $150/hr

Remote Role Responsibilities * Lead utilisation management and case management operations ... Active clinical licensure ( RN required ; physician advisor/ MD preferred ) with strong medical ...

Oshi Health

GI- Nurse Practitioner

New Brunswick, NJ · Remote

Preferred RN compact License Required Location: We are only hiring from the following states ... Remote-first -- work from home anywhere in the US within our approved states * Growth: Advanced ...

Baba

Virtual Nurse Practitioner

New York, NY · Remote

Telehealth Nurse Practitioner | Remote 1099 | Structured Intake & Care Navigation About Baba Baba ... Baba's insurance-covered advocates have supported thousands of families by writing insurance ...

MedReview

DRG Clinical Validation Nurse

New York, NY · Remote

$85K - $95K/yr

We are seeking a registered nurse with experience in clinical validation to work within our coding ... Knowledge of health insurance business, industry terminology, and regulatory guidelines ...

Oscar Health

NP/PA - Virtual Urgent Care

New York, NY · Remote

$116K - $152K/yr

Remote Oscar Medical Group is a blended work culture where everyone, regardless of work type or ... Collaborate with MAs, RNs, and other providers across service lines (e.g. primary care and health ...

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All JobsRn Insurance JobsRemote Rn Insurance JobsRemote Rn Insurance Jobs in New Brunswick, NJ

Remote Rn Insurance information

See New Brunswick, NJ salary details

$7

$43

$74

How much do remote rn insurance jobs pay per hour?

As of Aug 6, 2026, the average hourly pay for remote rn insurance in New Brunswick, NJ is $43.62, according to ZipRecruiter salary data. Most workers in this role earn between $32.50 and $51.63 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Remote RN Insurance nurse?

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 popular job titles related to Remote Rn Insurance jobs in New Brunswick, NJ? For Remote Rn Insurance jobs in New Brunswick, NJ, the most frequently searched job titles are:
What job categories do people searching Remote Rn Insurance jobs in New Brunswick, NJ look for? The top searched job categories for Remote Rn Insurance jobs in New Brunswick, NJ are:
What cities near New Brunswick, NJ are hiring for Remote Rn Insurance jobs? Cities near New Brunswick, NJ with the most Remote Rn Insurance job openings:
Remote Rn Insurance jobs near you
Infographic showing various Remote Rn Insurance job openings in New Brunswick, NJ as of August 2026, with employment types broken down into 1% As Needed, 70% Full Time, 21% Part Time, 2% Temporary, and 6% Contract. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $90,737 per year, or $43.6 per hour.

RN II - Primary Nurse Care

Horizon Blue Cross Blue Shield of New Jersey

Hopewell, NJ • On-site, Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 7 days ago

Horizon Blue Cross Blue Shield of New Jersey rating

8.0

Company rating: 8.0 out of 10

Based on 22 frontline employees who took The Breakroom Quiz

163rd of 301 rated insurance

Job description

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds.
About the Role
This position is responsible for performing RN duties for the Primary Nurse population using established guidelines to ensure appropriate level of care, as well as, planning for the transition to the continuum of care and developing a member centric plan of care. Primary Nurses will outreach to high risk members and will work to engage members in preventative care opportunities & screenings when possible. This position will perform duties and types of care management as assigned by management. Serves as a mentor/trainer to new RN's and other staff as needed. Positions involving ASO accounts may require some travel for on-site availability.
What You'll Do
  • Assesses member's clinical need against established guidelines and/or standards to ensure that the services provided are medically appropriate to member's needs and aligned with the benefit structure.
  • Facilitates response to gaps in care and identified high risk members to appropriate settings of care for annual wellness visits including collaboration with treating provider.
  • Evaluates the necessity, appropriateness and efficiency of medical services and procedures provided for both acute and chronic health care needs.
  • Develops, coordinates and assists in implementation of individualized plan of care for members and identification of barriers towards Self-Management and optimal wellness.
  • Coordinates with members, family, physician, hospital and other external customers with respect to the appropriateness of care from diagnosis to outcome.
  • Coordinates the delivery of high quality, cost-effective care supported by clinical practice guidelines established by the plan addressing the entire continuum of care including transitional care.
  • Monitors member's medical care activities, regardless of the site of service, and outcomes for appropriateness and effectiveness.
  • Advocates for the member/family among various sites to coordinate resource utilization and evaluation of services provided.
  • Encourages member participation and compliance in the case/disease management program efforts.
  • Documents accurately and comprehensively based on the standards of practice and current organization policies.
  • Interacts and communicates with multidisciplinary teams either telephonically and/or in person striving for continuity and efficiency as the member is managed along the continuum of care.
  • Evaluates care by problem solving, analyzing variances and participating in the quality improvement program to enhance member outcomes.
  • Serves as mentor/trainer to new RN's and other staff as needed
  • Presents clinical cases during audits conducted by external review organizations.
  • Performs other duties as assigned by management.

What You Bring
Education/Experience:
  • High School Diploma/GED required.
  • Bachelor degree preferred or relevant experience in lieu of degree.
  • Requires a minimum of two (2) years clinical experience. Experience with both acute and chronic conditions preferred.
  • Requires a minimum of three (3) years' experience in the health care delivery system/industry.
  • Experience with health care payer experience strongly preferred.

Additional licensing, certifications, registrations:
  • Active Unrestricted RN License Required; NJ License required and/or Compact License.
  • Requires a valid Driver's License and Insurance.

Knowledge:
  • Requires proficiency in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, and PowerPoint) and Microsoft Outlook. Prefers knowledge in the use of intranet and internet applications.
  • Requires working knowledge of case/care/disease management principles.
  • Requires working knowledge of operations of utilization, case and/or disease management processes.
  • Requires working knowledge of principles of utilization management.
  • Requires basic knowledge of health care contracts and benefit eligibility requirements.
  • Requires knowledge of hospital structures and payment systems.
  • Prefers understanding of fiscal accountability and its impact on the utilization of resources, proceeding to self-care outcomes.

Skills and Abilities:
  • Bi-lingual proficiency preferred.
  • Adaptability/Flexibility.
  • Analytical.
  • Compassion.
  • Information/Knowledge Sharing.
  • Interpersonal & Client Relationship.
  • Sound decision making.
  • Active listening.
  • Organization Planning/Priority Setting.
  • Problem Solving/Critical Thinking.
  • Team Player.
  • Time Management.
  • Written/Oral Communications.

Travel:
  • Travel primarily within State of NJ may be required. Occasional travel in the tri-state area may also be required.

Why Horizon?
At Horizon, you'll do meaningful work that directly improves lives-while being supported by a mission-driven organization that values expertise, collaboration, and growth. We believe that when our people thrive, our communities do too. If you are passionate about making an impact, we'd love to hear from you!
Salary Range:
$79,100 - $105,945
This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:
  • Comprehensive health benefits (Medical/Dental/Vision)
  • Retirement Plans
  • Generous PTO
  • Incentive Plans
  • Wellness Programs
  • Paid Volunteer Time Off
  • Tuition Reimbursement

Disclaimer:
Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware. This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job.
Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.

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