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Remote Rn Insurance Jobs in West Roxbury, MA (NOW HIRING)

BetterHelp

Licensed Psychologist - Remote

Boston, MA · Remote

No insurance headaches. No clawbacks. No payment delays. We handle everything -- you get paid ... Also, we are unable to accept substance abuse counselors, school counselors, registered nurses ...

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All JobsRn Insurance JobsRemote Rn Insurance JobsRemote Rn Insurance Jobs in West Roxbury, MA

Remote Rn Insurance information

See West Roxbury, MA salary details

$7

$43

$73

How much do remote rn insurance jobs pay per hour?

As of Aug 22, 2026, the average hourly pay for remote rn insurance in West Roxbury, MA is $43.27, according to ZipRecruiter salary data. Most workers in this role earn between $32.26 and $51.20 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 cities near West Roxbury, MA are hiring for Remote Rn Insurance jobs?

Cities near West Roxbury, MA with the most Remote Rn Insurance job openings:

Remote Rn Insurance jobs near you
Infographic showing various Remote Rn Insurance job openings in West Roxbury, MA as of August 2026, with employment types broken down into 100% Part Time. Highlights an 100% Remote job distribution, with an average salary of $90,002 per year, or $43.3 per hour.

RN Clinical Coordinator

University of Massachusetts Medical School

Westborough, MA • On-site, Remote

$90K - $100K/yr

Full-time

Re-posted 21 days ago

Job description

Job Summary

Under the general direction of the Associate Director, or designee, the Clinical Coordinator is responsible to develop, prioritize, and oversee staff activities specifically designed to promote the coordination of care for those MassHealth members who have medically complex, chronic or catastrophic illnesses that require a customized approach to how, when, and where they receive medically necessary health care services. This position provides leadership for the ongoing development of clinical competence and practice. In collaboration with colleagues, this position will supervise and implement improvements to clinical review activities.


Major Responsibilities

  • Provide clinical direction, supervision, and support to the clinical review team’s determination of eligibility and/or authorize services for members in accordance with program guidelines and regulations.
  • Supervise and perform the approval, modification or denial of requested services consistent with established procedural standards and MassHealth program rules and regulations to monitor provider compliance.
  • Participate in on-site visits to MassHealth providers, long-term care facilities, rehab facility, acute care facility and/or consumer’s residence, as necessary.
  • Collaborate with other Executive Office of Health and Human Services’ Agencies regarding the issues of various MassHealth populations.
  • Research MassHealth regulations and interpret these regulations for providers and clinical review team
  • Provide clinical support to MassHealth program managers, and design and present training sessions for in-house staff or MassHealth providers as necessary.
  • Review and propose changes to applicable MassHealth program regulations, policies, and other documents.
  • Coordinate contacts with MassHealth providers to respond to inquiries pertaining to specific program areas.
  • Prepare and respond to inquiries related to appeals following clinical determinations
  • Foster team environment, and provide professional and clinical leadership to team members, including consultants, providers and administrative support staff as appropriate.
  • Direct team members in identifying and addressing issues involving clinical matters.
  • Interface with state agencies and providers regarding clinical determination of medical necessity and program compliance.
  • Communicate policy, workflow and organizational changes to team members.
  • Provide orientation and ongoing in-service/continuing education programs for team members.
  • Conduct performance evaluations of team members.
  • Participate in the hiring and termination of team members.
  • Work closely with Director and other management staff to ensure clinical integrity is maintained in the clinical eligibility and nurse reviewer processes.
  • Maintain confidentiality of all business documents and correspondence.
  • In collaboration with the Director and other management staff to coordinate performance improvement and quality assurance activities.
  • Attend and participate in meetings as required.
  • Prepare written reports/determinations as requested.
  • Travel to and from providers’ places of business, state agency offices, long-term care or rehab facilities, acute care facilities and/or consumer’s residence.
  • Perform other related duties as required or assigned.

Required Qualifications

BA/BS in a related field or equivalent experience required OR RN licensed to practice in Massachusetts

AND:

  • 5-10 years of related work experience with at least 2 years supervisory or management experience in a clinical care coordination role
  • Ability to interpret appropriate regulations
  • Ability to work independently and collaboratively
  • Experience with Word and Excel and other desktop tools
  • Ability to travel statewide to member/applicant/participant homes and service providers places of business
  • Valid driver’s license required

Preferred Qualifications 

  • 3 years of related work experience with prior authorization and/or eligibility determinations for disabled, medically complex, home care, rehab or long term care populations strongly preferred
  • Knowledge of MassHealth Hearing and Appeals process preferred
  • Knowledge of MassHealth regulations preferred
  • Strong analytical and problem solving skills preferred
  • Professional certifications are preferred

Supervision

Supervision received from Associate Director

Supervision Exercised

Supervision exercised over a team of clinicians

Environmental Working Conditions

Remote/desk work with- some statewide travel may be required

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