This is a full-time remote opportunity. Current States Eligible MA and CT SCHEDULE: * Monday ... CurrentMA RN License, required * Bachelor's degree, required * 3-5 years nursing experience
This is a full-time remote opportunity. Current States Eligible MA and CT SCHEDULE: * Monday ... CurrentMA RN License, required * Bachelor's degree, required * 3-5 years nursing experience
Clinical Operations Director (Premium) - Evernorth Health Services -Remote
Bloomfield, CT · On-site +1
Active Unencumbered Registered Nurse (RN) license required. * Minimum of 10 years of experience in healthcare operations, case management, or clinical program leadership. * Demonstrated leadership ...
Clinical Operations Director (Premium) - Evernorth Health Services -Remote
Bloomfield, CT · On-site +1
Active Unencumbered Registered Nurse (RN) license required. * Minimum of 10 years of experience in healthcare operations, case management, or clinical program leadership. * Demonstrated leadership ...
Strategic Clinical Quality Manager - North Connecticut and Western Mass Areas
Springfield, MA · Remote
$79.60K - $142.30K/yr
Remote: The position could require travel up to 10-15% SUPERVISION: * None EDUCATION AND REQUIRED CREDENTIALS : * Registered Nurse required * BSN or bachelor's degree in healthcare-related field ...
Strategic Clinical Quality Manager - North Connecticut and Western Mass Areas
Springfield, MA · Remote
$79.60K - $142.30K/yr
Remote: The position could require travel up to 10-15% SUPERVISION: * None EDUCATION AND REQUIRED CREDENTIALS : * Registered Nurse required * BSN or bachelor's degree in healthcare-related field ...
Strategic Clinical Quality Manager - North Connecticut and Western Mass Areas
Springfield, MA · On-site +1
$79.60K - $142.30K/yr
Remote: The position could require travel up to 10-15% SUPERVISION: * None EDUCATION AND REQUIRED CREDENTIALS : * Registered Nurse required * BSN or bachelor's degree in healthcare-related field ...
Strategic Clinical Quality Manager - North Connecticut and Western Mass Areas
Springfield, MA · On-site +1
$79.60K - $142.30K/yr
Remote: The position could require travel up to 10-15% SUPERVISION: * None EDUCATION AND REQUIRED CREDENTIALS : * Registered Nurse required * BSN or bachelor's degree in healthcare-related field ...
Territory Manager, Infusion Therapies and Platforms (Connecticut/Rhode Island)
Springfield, MA · Remote
$96K - $132K/yr
... Nursing, Pharmacy, Risk Management, and other departments throughout the hospital in the ... Willingness to travel to both remote and urban locations, independently or with other personnel.
Territory Manager, Infusion Therapies and Platforms (Connecticut/Rhode Island)
Springfield, MA · Remote
$96K - $132K/yr
... Nursing, Pharmacy, Risk Management, and other departments throughout the hospital in the ... Willingness to travel to both remote and urban locations, independently or with other personnel.
While this is a remote position not located at a physical Medtronic site, the candidate hired will ... Registered nurse or HCP with experience in a sterile environment * Clinical experience with ...
While this is a remote position not located at a physical Medtronic site, the candidate hired will ... Registered nurse or HCP with experience in a sterile environment * Clinical experience with ...
Sr. Sales Representative, Coronary, Hartford, CT
Hartford, CT · Remote
$110K - $225K/yr
... RN) background with cath lab exposure. Specialized Skills / Other Requirements * Proven track ... LI-SM1 #LI-remote At Teleflex, we follow a comprehensive hiring process. We do not accept ...
Sr. Sales Representative, Coronary, Hartford, CT
Hartford, CT · Remote
$110K - $225K/yr
... RN) background with cath lab exposure. Specialized Skills / Other Requirements * Proven track ... LI-SM1 #LI-remote At Teleflex, we follow a comprehensive hiring process. We do not accept ...
VP, Clinical Insights, Innovation, & Policy - Aetna
Hartford, CT · On-site +1
$250K - $350K/yr
Remote or HybridQualifications * 15+ years of progressive leadership experience in healthcare, with ... Clinical degree (e.g., MD, DO, RN, PharmD) would be valued but not required * Previous experience ...
VP, Clinical Insights, Innovation, & Policy - Aetna
Hartford, CT · On-site +1
$250K - $350K/yr
Remote or HybridQualifications * 15+ years of progressive leadership experience in healthcare, with ... Clinical degree (e.g., MD, DO, RN, PharmD) would be valued but not required * Previous experience ...
Remote Rn information
How to Become a Remote RN?
To become a remote nurse, you need the same training, education, and qualifications that non-remote nurses possess, namely nursing licensure in your state. Some virtual RN roles may also require some period of on-site training to learn procedures. Since your duties include performing patient triage via telephone, webcam, or chat apps, you also need strong technical skills and a high-speed internet connection. Fluency in more than one language is a big plus, as is a strong track record of success in self-directed roles. Additionally, a variety of telehealth certifications are available, and these increase your appeal with potential employers.
What are the key skills and qualifications needed to thrive as a Remote RN, and why are they important?
What are some common challenges remote RNs face and how can they overcome them?
What are Remote RNs?
What is the difference between Remote Rn vs Remote Lpn?
| Aspect | Remote Rn | Remote Lpn |
|---|---|---|
| Required Credentials | Registered Nurse (RN) license, BSN often preferred | Licensed Practical Nurse (LPN) license |
| Work Environment | Hospitals, clinics, telehealth platforms | Long-term care, home health, telehealth |
| Employer & Industry Usage | Hospitals, healthcare providers, telehealth companies | Long-term care facilities, home health agencies |
Remote Rns typically hold a registered nurse license and work in hospitals or telehealth settings, providing comprehensive patient care. Remote Lpns, with a practical nurse license, often work in long-term care or home health. While both roles involve remote patient interaction, Rns usually handle more complex cases, whereas Lpns focus on basic patient care tasks.

Full-time
Medical, Dental, Vision, Life, PTO
Posted 21 days ago
Baystate Health rating
6.5
Based on 137 frontline employees who took The Breakroom Quiz
593rd of 864 rated healthcare providers
Job description
UM Inpatient Clinical Review Nurse- Baystate Health, Health New England
The UM Inpatient Clinical Review Nurse contributes to the overall success of the Utilization Management department by performing clinical reviews forinpatient, includingdeterminingthe member's overall health, reviewing the type of care being delivered,andevaluating medical necessity, in compliance with governing regulations, internal policies, and procedures.
Responsibilities
- Performs pre-service,concurrent, and retrospectivereviews of membersforappropriate careand setting todetermineoverall health andappropriate levelof care, using applicable coverage documents and clinical guidelines
- Collects, documents, andmaintainsreview findingsand actions taken on member medical records in health management systems, according toutilizationmanagement policies and guidelines
- Works with healthcare providers to approve medical determinations or provide recommendations based on requested service and review findings
- Collaborateswith MedicalDirectors,whendetermination to deny a request is indicated
- Assistswith providing education to providers onutilizationprocesses to ensure high quality,appropriate careto members
- Collaborates with care management on referral of members, as appropriate
- Performs clinical reviews for member and provider appeals related toinpatient services
- Participates in the weekend call program, as well as flexible work hours, as needed within the department
- Provides input to the Medical Policy Committeeregardingthe development/updating of medical policies
LOCATION:
This is a full-time remote opportunity. Current States Eligible MA and CT
SCHEDULE:
- Monday through Friday
- 6 weekends/ 1 holiday a year
- Flex schedule: 7:30-4:00pm, 8:00-4:30pm, 1 week a month working 8:30am-5:00pm
REQUIREMENTS:
- CurrentMA RN License, required
- Bachelor's degree, required
- 3-5 years nursing experience
- Knowledge ofutilizationmanagement, Medicare and Medicaid strongly preferred
- Highly developed critical thinking skills- prior nursing experience ICU or ER
- Computer literacy and ability to navigate through computer systems
- Excellent written and verbal communication skills, including delivering presentations
- Excellent time management skills with the ability to manage multiple priorities
- Ability to manage an assigned caseload independently
- Strong teamwork skills
THE ADVANTAGES OF WORKING WITH BAYSTATE/HEALTH NEW ENGLAND!
- Competitive High-quality, low-cost medical, dental and vision insurance
- Generous PTO
- Continuing education support and reimbursement
- Wellbeing programs that include but are not limited to mental, physical, and financial health
- Pet, home, auto and personal insurance
- Life insurance
- Reimbursement for a variety of wellbeing activities, included but limited to gym membership and equipment, personal trainer, massage and so much more!
About Health New England
Based in Springfield, Massachusetts, part of Baystate Health, Health New England is a regional not-for-profit health plan serving over 160,000 members in central and western Massachusetts and parts of Connecticut. Health New England has been meeting the health care needs of its members for nearly 40 years. Health New England is committed to improving the health and lives of people of our community, both in our workplace and for our members. We are committed to creating opportunities for individuals of all backgrounds to grow and thrive.
Working Conditions
Standard office environment, with extendedperiod of timesitting, looking at monitors, typing on laptops and
communicatingvia softphones/headsets for virtual meetings. No travelingrequired.
Education:
Bachelors Degree (Required)Certifications:
Compensation
Note: The compensation range(s) in the table below represent the base salaries for all positions at a given grade across the health system. Typically, a new hire can expect a starting salary somewhere in the lower part of the range. Actual salaries may vary by position and will be determined based on the candidate's relevant experience. No employee will be paid below the minimum of the range. Pay ranges are listed as hourly for non-exempt employees and based on assumed full time commitment for exempt employees.
Minimum - Midpoint - Maximum
$89,606.00 - $103,001.00 - $121,804.00Equal Employment Opportunity Employer
Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.
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