Madison, WI · Remote
$72.70K - $116.60K/yr
Other RN licenses, if applicable, must be obtained within the first 6 months. Preferred : Certification in Case Management Skills Written and verbal presentation, negotiation, and influencing skills ...
Madison, WI · Remote
$72.70K - $116.60K/yr
Other RN licenses, if applicable, must be obtained within the first 6 months. Preferred : Certification in Case Management Skills Written and verbal presentation, negotiation, and influencing skills ...
Madison, WI · Remote
$90.70K - $123.40K/yr
... reviews. The role also leads the development and execution of corrective action plans in response ... Registered Nurse (RN) required * Bachelor's degree in Nursing preferred Experience: * Minimum of ...
Madison, WI · Remote
$90.70K - $123.40K/yr
... reviews. The role also leads the development and execution of corrective action plans in response ... Registered Nurse (RN) required * Bachelor's degree in Nursing preferred Experience: * Minimum of ...
Madison, WI · Remote
$90.70K - $123.40K/yr
... reviews. The role also leads the development and execution of corrective action plans in response ... Registered Nurse (RN) required * Bachelor's degree in Nursing preferred Experience: * Minimum of ...
Madison, WI · Remote
$90.70K - $123.40K/yr
... reviews. The role also leads the development and execution of corrective action plans in response ... Registered Nurse (RN) required * Bachelor's degree in Nursing preferred Experience: * Minimum of ...
Madison, WI · On-site +1
$90.70K - $123.40K/yr
... reviews. The role also leads the development and execution of corrective action plans in response ... Registered Nurse (RN) required * Bachelor's degree in Nursing preferred Experience: * Minimum of ...
Madison, WI · On-site +1
$90.70K - $123.40K/yr
... reviews. The role also leads the development and execution of corrective action plans in response ... Registered Nurse (RN) required * Bachelor's degree in Nursing preferred Experience: * Minimum of ...
Madison, WI · Remote
$61.05K - $98.33K/yr
... ies), reviews medical data in CareMC, validates and secures medical information, assesses and ... This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Initiates and receives telephonic ...
Quick apply
Madison, WI · Remote
$61.05K - $98.33K/yr
... ies), reviews medical data in CareMC, validates and secures medical information, assesses and ... This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Initiates and receives telephonic ...
Madison, WI · Remote
$61.05K - $98.33K/yr
... ies), reviews medical data in CareMC, validates and secures medical information, assesses and ... This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Initiates and receives telephonic ...
Madison, WI · Remote
$61.05K - $98.33K/yr
... ies), reviews medical data in CareMC, validates and secures medical information, assesses and ... This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Initiates and receives telephonic ...
Madison, WI · Remote
$61.05K - $98.33K/yr
... ies), reviews medical data in CareMC, validates and secures medical information, assesses and ... This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Initiates and receives telephonic ...
Madison, WI · Remote
$61.05K - $98.33K/yr
... ies), reviews medical data in CareMC, validates and secures medical information, assesses and ... This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Initiates and receives telephonic ...
Oregon, WI · Remote
$50 - $60/hr
... Registered Nurses Therapists Physical Therapists Occupational Therapists Speech-Language ... REMOTE position You'll be able to choose which projects you want to work on You can work on your ...
Oregon, WI · Remote
$50 - $60/hr
... Registered Nurses Therapists Physical Therapists Occupational Therapists Speech-Language ... REMOTE position You'll be able to choose which projects you want to work on You can work on your ...
Oregon, WI · Remote
$50 - $60/hr
... Registered Nurses Therapists Physical Therapists Occupational Therapists Speech-Language ... REMOTE position You'll be able to choose which projects you want to work on You can work on your ...
Oregon, WI · Remote
$50 - $60/hr
... Registered Nurses Therapists Physical Therapists Occupational Therapists Speech-Language ... REMOTE position You'll be able to choose which projects you want to work on You can work on your ...
Madison, WI · On-site +1
$110K - $130K/yr
Active license as an RN in the State of Wisconsin or a valid multi-state compact license. * 7 or ... Please review Remote Worker FAQs for additional information. Benefits * Remote and hybrid work ...
Madison, WI · On-site +1
$110K - $130K/yr
Active license as an RN in the State of Wisconsin or a valid multi-state compact license. * 7 or ... Please review Remote Worker FAQs for additional information. Benefits * Remote and hybrid work ...
Madison, WI · On-site +1
$110K - $130K/yr
Active license as an RN in the State of Wisconsin or a valid multi-state compact license. * 7 or ... Please review Remote Worker FAQs for additional information. Benefits * Remote and hybrid work ...
Madison, WI · On-site +1
$110K - $130K/yr
Active license as an RN in the State of Wisconsin or a valid multi-state compact license. * 7 or ... Please review Remote Worker FAQs for additional information. Benefits * Remote and hybrid work ...
Madison, WI · On-site +1
$111.97K - $156.76K/yr
This will include every other weekend and will include holidays as scheduled. This will be a hybrid ... Active RN and APRN certifications and licenses, including prescriptive authority, in state(s) of ...
Madison, WI · On-site +1
$111.97K - $156.76K/yr
This will include every other weekend and will include holidays as scheduled. This will be a hybrid ... Active RN and APRN certifications and licenses, including prescriptive authority, in state(s) of ...
Madison, WI · On-site +1
$17.75/hr
Partner with the RN team to ensure appeals requiring medical documentation are reviewed by ... Remote Work Requirements * High speed cable or fiber internet * Minimum of 10 Mbps downstream and ...
Madison, WI · On-site +1
$17.75/hr
Partner with the RN team to ensure appeals requiring medical documentation are reviewed by ... Remote Work Requirements * High speed cable or fiber internet * Minimum of 10 Mbps downstream and ...
Madison, WI · Remote
$58.75 - $70.50/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Collaborate with physicians, nurses, and medical directors on complex cases. * Document outcomes in ...
Madison, WI · Remote
$58.75 - $70.50/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Collaborate with physicians, nurses, and medical directors on complex cases. * Document outcomes in ...
Madison, WI · On-site +1
$17.75/hr
Partner with the RN team to ensure appeals requiring medical documentation are reviewed by ... Remote Work Requirements * High speed cable or fiber internet * Minimum of 10 Mbps downstream and ...
Madison, WI · On-site +1
$17.75/hr
Partner with the RN team to ensure appeals requiring medical documentation are reviewed by ... Remote Work Requirements * High speed cable or fiber internet * Minimum of 10 Mbps downstream and ...
Oregon, WI · Remote
$50 - $60/hr
... MidwivesCertified Registered Nurse AnesthetistsClinical Nurse SpecialistsRegistered ... remote positionYou'll be able to choose which projects you want to work onYou can work on your own ...
Oregon, WI · Remote
$50 - $60/hr
... MidwivesCertified Registered Nurse AnesthetistsClinical Nurse SpecialistsRegistered ... remote positionYou'll be able to choose which projects you want to work onYou can work on your own ...
This is a fully remote, 1099 contractor opportunity offering flexibility, strong patient demand ... Nurse Practitioners (PMHNPs): * Initial evaluations (30 min): ~$45 per visit * Follow-ups (15 min ...
Quick apply
This is a fully remote, 1099 contractor opportunity offering flexibility, strong patient demand ... Nurse Practitioners (PMHNPs): * Initial evaluations (30 min): ~$45 per visit * Follow-ups (15 min ...
Madison, WI · On-site +1
$57.75 - $70.25/hr
Collaborate with physicians, nurses, and medical directors during case reviews. * Track, document ... Many roles offer hybrid or fully remote options. * Rewards: Competitive salary, comprehensive ...
Madison, WI · On-site +1
$57.75 - $70.25/hr
Collaborate with physicians, nurses, and medical directors during case reviews. * Track, document ... Many roles offer hybrid or fully remote options. * Rewards: Competitive salary, comprehensive ...
Madison, WI · On-site +1
$45.69K - $71.63K/yr
Madison West Clinic Telework/Virtual/Remote: This position is NOT eligible. Financial Disclosure ... Completed work should need only a general review by a registered nurse (RN) or physician (MD/DO ...
Madison, WI · On-site +1
$45.69K - $71.63K/yr
Madison West Clinic Telework/Virtual/Remote: This position is NOT eligible. Financial Disclosure ... Completed work should need only a general review by a registered nurse (RN) or physician (MD/DO ...
Madison, WI · On-site +1
$45.69K - $71.63K/yr
Madison West Clinic Telework/Virtual/Remote: This position is NOT eligible. Financial Disclosure ... Completed work should need only a general review by a registered nurse (RN) or physician (MD/DO ...
Madison, WI · On-site +1
$45.69K - $71.63K/yr
Madison West Clinic Telework/Virtual/Remote: This position is NOT eligible. Financial Disclosure ... Completed work should need only a general review by a registered nurse (RN) or physician (MD/DO ...
$24.22 - $28.45
5% of jobs
$28.45 - $32.68
15% of jobs
$34.35 is the 25th percentile. Wages below this are outliers.
$32.68 - $36.91
13% of jobs
$36.91 - $41.13
15% of jobs
The median wage is $41.95 / hr.
$41.13 - $45.36
14% of jobs
$45.36 - $49.59
11% of jobs
$51.31 is the 75th percentile. Wages above this are outliers.
$49.59 - $53.82
8% of jobs
$53.82 - $58.04
6% of jobs
$58.04 - $62.27
8% of jobs
$62.27 - $66.50
3% of jobs
$66.50 - $70.73
2% of jobs
$24
$45
$70
| Aspect | Weekend Remote Rn Chart Review | Weekend Remote Lpn Chart Review |
|---|---|---|
| Credentials | Registered Nurse (RN) license | Licensed Practical Nurse (LPN) license |
| Work Environment | Remote, healthcare facilities, insurance companies | Remote, healthcare facilities, insurance companies |
| Job Responsibilities | Comprehensive chart review, clinical decision support, detailed documentation | Basic chart review, data entry, preliminary assessments |
Both roles involve remote chart review in healthcare, but RNs perform more detailed clinical assessments and have advanced licensure, while LPNs handle more basic review tasks. The RN role typically requires more clinical experience and offers broader responsibilities, making it suitable for those with RN licensure seeking remote work on weekends.
$72.70K - $116.60K/yr
Full-time
This job post has expired today. Applications are no longer accepted.
7.8
Based on 28 frontline employees who took The Breakroom Quiz
Company Highmark Inc. Job Summary This position has primary ownership and oversight over a specified panel of members that range in health status, severity, and clinical needs. The incumbent assesses health management needs of the assigned member panel and, using data and analytics in conjunction with professional clinical judgement, identifies the right clinical intervention for each member.
Supported by a multidisciplinary team, the incumbent refers members to appropriate resources and manages an active case load of members enrolled in case management. The incumbent conducts outreach, develops care plans, encourages behavior changes, removes barriers, coordinates care, and identifies resources to help members achieve personal health goals. The incumbent monitors, improves, and maintains quality outcomes (clinical, financial, and functional) for the specified panel of members.
Essential Responsibilities Maintain oversight over a specified panel of members by performing ongoing assessment of health management needs, identifying appropriate clinical interventions, and triaging members to additional resources. For the assigned case load, create care plans that address identified needs, remove barriers to care, identify resources, and conduct activities to improve health outcomes; care plans include both long‐term and short‐term goals and regular contacts for reassessment. Ensure targeted percentage of member goal achievement and other patient outcomes are achieved.
Document all activities in compliance with business process requirements, regulatory requirements, and accreditation standards. Maintain current knowledge and adhere to CMS, state, local, and regulatory agency requirements and applicable standards of practice for case management, including those published by CMSA and/or ACMA. Perform other duties as assigned or requested.
Education Required : High School Diploma/GED Preferred : Bachelor's Degree in Nursing Experience Required : 7 years of clinical, case‐management, disease/condition‐management, provider operations, or health insurance experience. Preferred : Advanced training and experience in cognitive behavioral therapy (CBT), motivational interviewing, or dialectical behavior therapy (DBT). Experience working with diverse populations.
Understanding of the importance of cultural competency. Licenses and Certifications Required : Current State of PA RN licensure or current multi‐state licensure through eNLC (or WV/DE/NY). Other RN licenses, if applicable, must be obtained within the first 6 months.
Preferred : Certification in Case Management Skills Written and verbal presentation, negotiation, and influencing skills with respect and compassion. Broad knowledge of disease processes. Understanding of healthcare costs and the broader service delivery system.
Proficiency in MS Excel and strong analytic skills to interpret, evaluate, and act on clinical and financial data. Excellent interpersonal and consensus‐building skills, working with colleagues at all levels. Ability to work in a high‐performing team environment that requires flexibility.
Demonstrated ability to manage multiple priorities in a fast‐paced environment; strong organizational, time‐management, and project‐management skills. Self‐directed, self‐starter, able to work with indirect supervision and moderate autonomy. Language Requirement (Other than English) None Travel Requirement 0% – 25% Physical, Mental Demands and Working Conditions Office‐Based.
Heavy lifting: up to 10 lbs (rarely), 10–25 lbs (rarely), 25–50 lbs (rarely). Pay Range Minimum: $72,700.00 Maximum: $116,600.00 EEO Statement Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. #J-18808-Ljbffr
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A national blended health organization, Highmark Health and our leading businesses support millions of customers with products, services and solutions closely aligned to our mission of creating remarkable health experiences, freeing people to be their best. Headquartered in Pittsburgh, we're regionally focused in Pennsylvania, Delaware, West Virginia, and eastern and northwestern New York with customers in 50 states and the District of Columbia. We passionately serve individual consumers and fellow businesses alike. And our companies cover a diversified spectrum of essential health-related needs including health insurance, health care delivery, population health management, dental solutions, reinsurance solutions, and innovative, technology solutions. Our financial position reflects strength and stability, with our year-end 2022 consolidated revenues totaling $26 billion. And we're proud to carry forth an important legacy of compassionate care and philanthropy that began more than 170 years ago. This tradition of giving back, reinvesting and ensuring that our communities remain strong and healthy is deeply embedded in our culture, informing our decisions every day.
Health care and social assistance and insurance services
10,000+ Employees
Pittsburgh, PA, US
