Remote Tricare Rn Jobs in Springfield, MA (NOW HIRING)

Location: Hyannis, MA
Duration: 13 Weeks
Schedule: 4x8-Hour Shifts | 7:00 AM - 3:30 PM
Shift: Days | Rotating Weekends and Occasional Holidays

Local Pay Rate: $59 - $60 per hour (Based on Experience)

We are seeking an experienced Registered Nurse Case Manager with a strong background in Clinical Documentation Improvement (CDI) and acute care nursing. This remote position is responsible for conducting comprehensive medical record reviews, collaborating with physicians and healthcare teams, improving clinical documentation accuracy, and supporting compliance with regulatory and reimbursement requirements.

The ideal candidate will possess excellent analytical, communication, and critical-thinking skills, along with extensive knowledge of clinical documentation practices, Medicare guidelines, and healthcare regulations.

• Perform comprehensive and timely medical record reviews to ensure accurate clinical documentation.
• Identify opportunities for documentation improvement and develop clinically appropriate queries.
• Collaborate with physicians, nursing staff, and Health Information Management (HIM) professionals to improve documentation quality.
• Participate actively in CDI initiatives, team meetings, educational programs, and task force activities.
• Monitor and follow up on documentation queries to ensure timely resolution.
• Communicate effectively with healthcare providers regarding documentation opportunities and compliance requirements.
• Enter and maintain accurate information within the electronic medical record system.
• Resolve documentation discrepancies in collaboration with HIM staff.
• Support organizational clinical documentation strategies and quality improvement initiatives.
• Manage multiple priorities while maintaining productivity and accuracy.
• Provide exceptional customer service to patients, families, colleagues, and healthcare partners.
• Interpret and communicate Medicare Part A and Part B guidelines and their impact on reimbursement and DRG assignments.

• Graduate of an accredited Nursing program.
• Current and active Massachusetts Registered Nurse (RN) license.

• Recent acute care experience required, preferably in:
  • ICU
  • CCU
  • Medical/Surgical Nursing
• OR a minimum of four (4) years of recent Case Management experience within the past four years.
• Strong understanding of:
  • Pathophysiology and disease processes
  • Clinical documentation improvement practices
  • Regulatory compliance requirements
  • Medicare Part A and Part B guidelines

• Excellent organizational, analytical, and documentation skills.
• Strong written and verbal communication abilities.
• Critical thinking, problem-solving, and deductive reasoning skills.
• Ability to work independently and manage multiple priorities.
• Strong interpersonal and physician collaboration skills.
• Proficiency with electronic medical records and Windows-based software applications.
• Professional, positive, and customer-focused demeanor.

• Management or supervisory experience.
• Prior CDI experience in an acute care setting.

• Active Massachusetts Registered Nurse (RN) License.
• Basic Life Support (BLS) Certification - AHA.
• Certified Clinical Documentation Specialist (CCDS) Certification or successful completion of a CDI Competency Examination.

• Fully Remote Position.
• Must be available to work rotating weekends and occasional holidays as scheduled.
• Opportunity to contribute to quality improvement initiatives and clinical documentation excellence within a collaborative healthcare environment.

For more details reach at jknox@navitashealth.com or Call / Text at 732-791-4827.

About Navitas Healthcare, LLC: It is a certified WBENC and one of the fastest-growing healthcare staffing firms in the US providing Medical, Clinical and Non-Clinical services to numerous hospitals. We offer the most competitive pay for every position we cater. We understand this is a partnership. You will not be blindsided and your salary will be discussed upfront.