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Remote Rn Insurance Jobs in Washington, PA (NOW HIRING)

PharMerica

Pharmacist Consultant

Pittsburgh, PA · On-site +1

$56.50 - $68/hr

Lead care teams providing value to prescribers and nursing staff * Navigate cost containment ... The Pharmacist Consultant is a remote role and will be responsible for covering the following ...

PharMerica

Pharmacist Consultant

Pittsburgh, PA · On-site +1

$56.50 - $68/hr

Lead care teams providing value to prescribers and nursing staff * Navigate cost containment ... The Pharmacist Consultant is a remote role and will be responsible for covering the following ...

Skin Clique

Supervising Physician

Pittsburgh, PA · Remote

Additionally, you'll supervise Nurse Practitioners (NPs) and Physician Assistants (PAs) in your ... Medical Malpractice Insurance Coverage * Flexible & Remote Work * Access to industry expert ...

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All JobsRn Insurance JobsRemote Rn Insurance JobsRemote Rn Insurance Jobs in Washington, PA

Remote Rn Insurance information

See Washington, PA salary details

$6

$39

$67

How much do remote rn insurance jobs pay per hour?

As of Aug 18, 2026, the average hourly pay for remote rn insurance in Washington, PA is $39.26, according to ZipRecruiter salary data. Most workers in this role earn between $29.28 and $46.44 per hour, depending on experience, location, and employer.

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 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 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 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 the most commonly searched types of Rn Insurance jobs in Washington, PA?

The most popular types of Rn Insurance jobs in Washington, PA are:

What are popular job titles related to Remote Rn Insurance jobs in Washington, PA?

For Remote Rn Insurance jobs in Washington, PA, the most frequently searched job titles are:

What job categories do people searching Remote Rn Insurance jobs in Washington, PA look for?

The top searched job categories for Remote Rn Insurance jobs in Washington, PA are:

What cities near Washington, PA are hiring for Remote Rn Insurance jobs?

Cities near Washington, PA with the most Remote Rn Insurance job openings:

Remote Rn Insurance jobs near you
Infographic showing various Remote Rn Insurance job openings in Washington, PA as of August 2026, with employment types broken down into 1% As Needed, 71% Full Time, 22% Part Time, 1% Temporary, and 5% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $81,652 per year, or $39.3 per hour.

Clinical Pharmacy Specialist (Remote)- Care Management Team

UPMC Senior Communities

Pittsburgh, PA • On-site, Remote

$54.68 - $81.63/hr

Full-time

Posted 7 days ago

Job description

UPMC Health Plan is hiring a full-time Clinical Pharmacy Specialist to support the Care Management team within the Pharmacy Services department. This is a work-from-home position, working Monday through Friday 8:30 a.m. to 5:00 p.m. EST. This is a remote position.
Registration as a registered pharmacist (RPh), in the Commonwealth of Pennsylvania or eligibility for licensure by examination or reciprocity is required.
The Clinical Pharmacy Specialist provides clinical pharmacy expertise to the development, implementation and management of the pharmacy benefit. The clinical pharmacist assists in the management of pharmacy utilization and provides expertise in managing member care. These services will be provided in compliance with state and federal regulations, NCQA, standards, the mission, policies and procedures of Health Plan and Pharmacy Department. Individual should demonstrate professionalism and commitment to meet UPMCHP goals and objectives.
Responsibilities:
The Care Management Pharmacist is primarily responsible for:
  • Managing and evaluating therapeutic drug interventions and other clinical pharmacy programs for the purpose of controlling pharmacy trend and improving pharmacy quality measures, including member and provider interventions, and evaluating outcomes for these programs, as well as considering comprehensive research projects.
  • Regularly interacting with interdisciplinary care teams to help best coordinate care for our members. Provide innovative and applicable ideas in clinical program development, utilization management, formulary management, provider education, therapeutic substitution, MTM/DUR, and/or improvements in programs and edits that already exist, including improving operational efficiencies, developing new clinical edits, and developing new quality improvement initiatives.Implement these new ideas or improvements as approved, while also considering outcomes of the programs.
  • Develop and conduct Drug Utilization Review (DUR) activities, Medication Therapy Management (MTM), and other integrated programs with medical management. Create, develop, maintain, and enhance clinical reporting programs, including but not limited to physician specific reporting, alternative prescribing programs for utilization, assigned client plans, etc.

Additional responsibilities include:
  • Administrative: Participate in meetings, committees, and work groups both internally and externally as assigned. Maintain a solid understanding of the requirements of the Pennsylvania Department of Health, DPW, CMS and the National Committee for Quality Assurance, specifically as they relate to the expectations of pharmacy operations. Ensure compliance with regulatory and accreditation requirements of clinical functions.
  • Communication: Foster and maintain collaborative relationships with internal and external customers. Communicate pharmacy information as appropriate to members, employer groups, and providers. Develop communication materials to providers, including discussions regarding formulary changes/adherence, health education, medication compliance, and trend management.
  • Teaching and Education: Mentor students and assist in precepting for the residency program (if applicable).
  • Special Skills/Ability to Interact: Have ability to function independently, but support team concept. Behavior denotes reliability as demonstrated by prompt attendance and timeliness completing designated workload and follow-up. Conveys and maintains professional image while interacting with coworkers, providers, and clients. Honor client and patient confidentiality.
  • Provide innovative ideas for new and existing clinical program development, utilization management, formulary management, provider education, and therapeutic substitution programs. Work with employer clients, account management, and sales in meetings as assigned to improve the understanding of the pharmacy benefit, as well as offering recommendations.
  • Develop and revise various formularies for each line of business including sending communications, training of identified departments, updating all brochures, updating appropriate websites, and submitting change forms. Review new drugs in a timely manner and submit change forms as appropriate. Research adequately and be properly prepared for all P&T Committee meetings, ensuring all recommendations for both new drugs and new policies are appropriate and have been discussed with subject matter experts.
  • Present these assignments succinctly and at a suitable pace, and answering relevant questions.

Qualifications:
  • Bachelor of Science Degree in Pharmacy, and/or Doctor of Pharmacy Degree (Pharm.D.) from an accredited U.S. School of Pharmacy.
  • Experience in pharmacy benefit management, insurance, managed care preferred and be knowledgeable in therapeutic interventions and other cost containment programs.
  • Effective communication skills, both written and oral.
  • Must have strong analytical ability and organizational skills.
  • Computer literacy for pharmacy programming, word processing, data management.
  • Assessment of job related skills and competency will be reviewed annually via daily functioning, job-related documentation, department based competency programs, and continuing education activities.

Preferred Experience:
  • Care Management - Managed care residency or 1-3 years managed care experience or at least 3 years of direct patient pharmacy practice experience, engaging in counseling and clinical services.cy practice experience, engaging in counseling and clinical services.
    Licensure, Certifications, and Clearances:
    Registration as a registered pharmacist (RPh), in the Commonwealth of Pennsylvania or eligibility for licensure by examination or reciprocity.Continuing Education requirements met each bi-annual cycle for re-licensure, as evident by obtaining a minimum of 30 hours of continuing education every 2 years in structured pharmaceutical education as necessary by the state board.
  • Pharmacist
  • Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran

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