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Work From Home Stop Loss Rn Jobs in Appleton, WI

InsuraTec

Sales Representative (Remote)

De Pere, WI · Remote

Location: 100% Remote (Work From Home) About InsuraTec: InsuraTec is a leading provider in financial planning and insurance services. We're looking for driven individuals to join our team as Sales ...

InsuraTec

Sales Representative (Remote)

Menasha, WI · Remote

Location: 100% Remote (Work From Home) About InsuraTec: InsuraTec is a leading provider in financial planning and insurance services. We're looking for driven individuals to join our team as Sales ...

InsuraTec

Sales Representative (Remote)

Greenville, WI · Remote

Location: 100% Remote (Work From Home) About InsuraTec: InsuraTec is a leading provider in financial planning and insurance services. We're looking for driven individuals to join our team as Sales ...

InsuraTec

Sales Representative (Remote)

Bellevue, WI · Remote

Location: 100% Remote (Work From Home) About InsuraTec: InsuraTec is a leading provider in financial planning and insurance services. We're looking for driven individuals to join our team as Sales ...

InsuraTec

Sales Representative (Remote)

Hobart, WI · Remote

Location: 100% Remote (Work From Home) About InsuraTec: InsuraTec is a leading provider in financial planning and insurance services. We're looking for driven individuals to join our team as Sales ...

InsuraTec

Sales Representative (Remote)

Kaukauna, WI · Remote

Location: 100% Remote (Work From Home) About InsuraTec: InsuraTec is a leading provider in financial planning and insurance services. We're looking for driven individuals to join our team as Sales ...

InsuraTec

Sales Representative (Remote)

Neenah, WI · Remote

Location: 100% Remote (Work From Home) About InsuraTec: InsuraTec is a leading provider in financial planning and insurance services. We're looking for driven individuals to join our team as Sales ...

InsuraTec

Sales Representative (Remote)

Appleton, WI · Remote

Location: 100% Remote (Work From Home) About InsuraTec: InsuraTec is a leading provider in financial planning and insurance services. We're looking for driven individuals to join our team as Sales ...

InsuraTec

Sales Representative (Remote)

Green Bay, WI · Remote

Location: 100% Remote (Work From Home) About InsuraTec: InsuraTec is a leading provider in financial planning and insurance services. We're looking for driven individuals to join our team as Sales ...

InsuraTec

Sales Representative (Remote)

Allouez, WI · Remote

Location: 100% Remote (Work From Home) About InsuraTec: InsuraTec is a leading provider in financial planning and insurance services. We're looking for driven individuals to join our team as Sales ...

InsuraTec

Sales Representative (Remote)

Menasha, WI · Remote

Location: 100% Remote (Work From Home) About InsuraTec: InsuraTec is a leading provider in financial planning and insurance services. We're looking for driven individuals to join our team as Sales ...

InsuraTec

Sales Representative (Remote)

Oshkosh, WI · Remote

Location: 100% Remote (Work From Home) About InsuraTec: InsuraTec is a leading provider in financial planning and insurance services. We're looking for driven individuals to join our team as Sales ...

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Showing results 41-60

All JobsStop Loss Rn JobsWork From Home Stop Loss Rn JobsWork From Home Stop Loss Rn Jobs in Appleton, WI

Work From Home Stop Loss Rn information

See Appleton, WI salary details

$66.3K

$111.6K

$201K

How much do work from home stop loss rn jobs pay per year?

As of Aug 12, 2026, the average yearly pay for work from home stop loss rn in Appleton, WI is $111,598.00, according to ZipRecruiter salary data. Most workers in this role earn between $96,100.00 and $123,400.00 per year, depending on experience, location, and employer.

What is the difference between Work From Home Stop Loss Rn vs Work From Home Case Manager?

AspectWork From Home Stop Loss RnWork From Home Case Manager
CredentialsRN license, certifications in insurance or risk managementRN license, case management certification
Work EnvironmentHome-based, insurance and healthcare settingsHome-based, healthcare and insurance industries
Industry UsageInsurance companies, healthcare providersInsurance companies, healthcare organizations
Job FocusManaging stop loss insurance claims and riskCoordinating patient care and insurance processes

While both roles require RN licensure and healthcare knowledge, the Work From Home Stop Loss Rn focuses on managing insurance claims related to stop loss coverage, emphasizing risk assessment. In contrast, the Work From Home Case Manager concentrates on coordinating patient care and insurance processes. Both roles are home-based and serve the healthcare and insurance industries, but their primary responsibilities differ significantly.

What is a Work From Home Stop Loss RN?

A Work From Home Stop Loss RN is a registered nurse who works remotely, typically for insurance companies or third-party administrators, to review medical claims associated with stop loss insurance policies. Their main responsibility is to assess the medical necessity and appropriateness of claims that exceed certain thresholds, helping employers and insurers manage high-cost healthcare claims. These nurses use their clinical expertise to analyze medical records, communicate with providers, and ensure that claims are processed accurately and efficiently. Working from home allows them to perform these tasks virtually, often using secure digital platforms.

What are some common challenges faced by Work From Home Stop Loss RNs, and how can they be addressed?

Work From Home Stop Loss RNs often face challenges related to remote communication, maintaining up-to-date clinical knowledge, and managing a high volume of case reviews. Since collaboration is primarily virtual, it's important to develop strong written and verbal communication skills to effectively coordinate with physicians, case managers, and insurance teams. Staying current with clinical guidelines and leveraging digital tools for documentation and workflow management can help streamline responsibilities and ensure accurate decision-making. Building a structured daily routine and proactively seeking support from team leads or mentors can also help address feelings of isolation and ensure ongoing professional growth.

What are the key skills and qualifications needed to thrive as a Work From Home Stop Loss RN?

To thrive as a Work From Home Stop Loss RN, you need a current RN license, strong clinical assessment skills, and experience in utilization review or case management. Familiarity with health insurance systems, stop loss claims processes, and electronic medical record (EMR) platforms is typically required. Excellent attention to detail, critical thinking, and effective written communication are crucial soft skills for remote collaboration and accurate documentation. These abilities ensure accurate claim evaluations, regulatory compliance, and efficient coordination with insurers and healthcare providers.
What are popular job titles related to Work From Home Stop Loss Rn jobs in Appleton, WI? For Work From Home Stop Loss Rn jobs in Appleton, WI, the most frequently searched job titles are:
What job categories do people searching Work From Home Stop Loss Rn jobs in Appleton, WI look for? The top searched job categories for Work From Home Stop Loss Rn jobs in Appleton, WI are:
What cities near Appleton, WI are hiring for Work From Home Stop Loss Rn jobs? Cities near Appleton, WI with the most Work From Home Stop Loss Rn job openings:
Work From Home Stop Loss Rn jobs near you
Infographic showing various Work From Home Stop Loss Rn job openings in Appleton, WI as of August 2026, with employment types broken down into 65% Full Time, 25% Part Time, and 10% Contract. Highlights an 3% In-person, and 97% Remote job distribution, with an average salary of $111,598 per year, or $53.7 per hour.

RN Care Manager - Condition/Disease Management Focus

Network Health WI

Menasha, WI • On-site, Remote

Full-time

Posted 7 days ago

Job description

The Registered Nurse Care Manager provides case management services that are member-centric and include assessment, planning, facilitation, care coordination, evaluation and advocacy to all members across the healthcare continuum. The Care Manager advocates for options and services to meet an individual's and family's comprehensive health needs through communication and coordination of available resources to promote quality, cost-effective outcomes.
Location: Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required). Travel to the corporate office in Menasha is required occasionally for the position, including on first day.
Hours: 1.0 FTE, 40 hours per week, 8am - 5pm Monday through Friday
Check out our 2025 Community Report to learn a little more about the difference our employees make in the communities we live and work in. As an employee, you will have the opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood. You too, can be part of the team and making a difference. Apply to this position to learn more about our team.
Job Responsibilities:
  • Screen candidates for case management and when appropriate completes assessments, care plans with prioritized goals, interventions, and timeframes for re-assessment using evidence-based clinical guidelines. Evaluate and determine member needs based on clinical or behavioral information such as diagnosis, disease progression, procedures and other related therapies
  • Review results from medical or behavioral tests and procedures and updates care plan to reflect progress towards goals; close cases when expected goals/outcomes are achieved
  • Provide information and outreach regarding case or condition management activities to members, caregivers, providers and their administrative staff
  • Evaluate and process member referrals from physicians to other specialty providers
  • Assess, plan, facilitate and advocate for individuals to identify quality, cost effective interventions services and resources to ensure health needs are met
  • Works with members and families on self-management approaches using coaching techniques such as motivational interviewing
  • Educate the individual, his/her family and caretakers about case and condition management, the individual's health condition(s), medications, provider and community resources and insurance benefits to support quality, cost effective health outcomes.
  • Facilitate the coordination, communication and collaboration of the individual's care among his/her providers including tertiary, non-plan providers and community resources with the goal of controlling costs and improving quality.
  • Schedule visits with the individual and participates in facility-based care conferences as appropriate to ensure quality care, appropriate use of services, and transition planning.
  • Stay abreast of current best practices and new developments
  • Other duties as assigned

Job Requirements:
  • Graduation from accredited school of nursing
  • Bachelor's degree in Nursing preferred
  • RN licensure in the State of Wisconsin
  • Case Management certification preferred
  • Four years of clinical health care experience as a RN required
  • Chronic condition management experience preferred, especially:
    • Diabetes
    • Cardiac
    • Pulmonology
  • Previous experience in case management, utilization management, insurance, or managed care preferred
  • Experience with Medicare, Medicaid preferred

Network Health is an Equal Opportunity Employer
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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