Remote Medical Case Manager Jobs
Remote medical case manager jobs are open across the U.S. in health insurance, managed care, workers' compensation, and behavioral health, at remote-first insurers, distributed care management firms, and large health plans building out virtual teams. Employers hiring remotely right now include CorVel Corporation, Crawford & Company, and TRISTAR. See the openings below and apply to the ones that match your experience.
Find JobsOverview
Showing 5 of 41+ Remote Medical Case Manager jobs
Screen reader users may encounter difficulty with this site. For assistance with applying, please contact hr-accessibleapplication@osu.edu . If you have questions while submitting an application, please review these frequently asked questions .
Current Employees and Students:
If you are currently employed or enrolled as a student at The Ohio State University, please l og in to Workday to use the internal application process.
Welcome to The Ohio State University's career site. We invite you to apply to positions of interest. In order to ensure your application is complete, you must complete the following:
Ensure you have all necessary documents available when starting the application process. You can review the additional job description section on postings for documents that may be required.
Prior to submitting your application, please review and update (if necessary) the information in your candidate profile as it will transfer to your application.
Job Title:
Clinical Financial Case Mgr - RNDepartment:
Health System Shared Services | Revenue Cycle Clinical SupportScope of Position
Revenue Cycle Clinical Support Office (RCCS) is an area within Access and Revenue Cycle Management Shared Services responsible for Clinical Pre-Certification, Case Reviews, Pre-billing edits, in-patient account validations, supporting Utilization Management, Peer to Peer processes, complex billing scenarios, audits (governmental, commercial, compliance, and internal), clinical appeals and denial management. RCCS is integral to the Revenue Cycle and supports cash collection through preventing and appealing denials.
Position Summary
The Clinical Financial Case Manager - RN (CFCM-RN) implements and supports the philosophy, mission, values, standards, policies, and procedures of The Ohio State University Wexner Medical Center. The CFCM-RN functions within the multidisciplinary team to secure complex pre-authorizations and prevent/appeal clinical denials. The job duties require the utilization of clinical knowledge to interpret and apply medical necessity guidelines to determine appropriateness for services provided. The CFCM-RN makes determinations on the appropriate level of care (Inpatient or Observation) based on the ability to read, understand, and interpret documented clinical
information. The role requires CFCM-RNs to become Subject Matter Experts (SME) for assigned payers as well as governmental payer requirements and audits such as RAC, MAC, QIO, etc. The CFCM-RN maintains an awareness of State and National Health care trends, JCAHO, CMS, and third-party payer Utilization Management guidelines.
The Financial aspect of the role involves acquiring knowledge of Managed Care, Scheduling, Financial Counseling, Pre-Certification, Admissions/Discharges/Transfers, Clinical workflows and documentation, Revenue Management, Charge Description Master, Coding (Diagnosis, HCPCS, Revenue Codes, Procedure Codes, Modifiers, etc.), Medical Information Management, Release of Information, Case Management, Utilization Management, Clinical Documentation Improvement, Compliance, Legal, Finance, Transplant workflows, Billing, Follow Up, Cash Posting, and any other areas that maybe needed to complete the tasks. The CFCM-RN must be able to read, understand and interpret a payer remit, denial/remark codes, and expected reimbursement to determine the cost effectiveness of completing an appeal.
The CFCM-RN must be versatile, flexible, and very adaptable to change because the payer rules change constantly. The CFCM-RN must be able to troubleshoot, problem solve, continuously learn, be highly independent, self-motivated and have an elevated level of interpretive skills and the ability to work closely with departments such as Legal, Medical Information Management, Physician groups and the Business Office.
Minimum Qualifications For Hire Required:
- Bachelor’s degree in nursing with current license required.
- Minimum of 2 years clinical care experience, caring for patients, anticipating their needs, and understanding the physician’s
plan of care.
- Experience collaborating with physicians and their designees.
- Strong, proven analytical skills. Ability to make educated decisions.
- Extensive knowledge of clinical operations and patient flow.
- Skilled at synthesizing large volumes of information and concisely communicating either verbally or in writing.
- Proficient in Microsoft Office Products such as: Word, Power Point, Excel, SharePoint, Teams, OneNote, etc.
- Proficient in Adobe Professional Proficient in using email, fax machines, copy machines, internet browsers.
- Proficient at typing
- Proficient in Technology, Computer, and Web applications. Must be able to multitask and move between applications quickly and frequently. Must be able to orientate self to new applications quickly. Must be able to manage complexities of having to work in multiple applications such as IHIS, MS Office products, 3M, and all payer websites/applications.
FUNCTION: Finance
SUB FUNCTION: Clinical Financial Case Management RN
CAREER BAND: Individual Contributor - Specialized
CAREER LEVEL: 2
Additional Information:
Location:
Remote LocationPosition Type:
RegularScheduled Hours:
40Shift:
First ShiftFinal candidates are subject to successful completion of a background check. A drug screen or physical may be required during the post offer process.
Thank you for your interest in positions at The Ohio State University and Wexner Medical Center. Once you have applied, the most updated information on the status of your application can be found by visiting the Candidate Home section of this site. Please view your submitted applications by logging in and reviewing your status. For answers to additional questions please review the frequently asked questions .
The university is an equal opportunity employer, including veterans and disability.
Screen reader users may encounter difficulty with this site. For assistance with applying, please contact hr-accessibleapplication@osu.edu . If you have questions while submitting an application, please review these frequently asked questions .
Current Employees and Students:
If you are currently employed or enrolled as a student at The Ohio State University, please l og in to Workday to use the internal application process.
Welcome to The Ohio State University's career site. We invite you to apply to positions of interest. In order to ensure your application is complete, you must complete the following:
Ensure you have all necessary documents available when starting the application process. You can review the additional job description section on postings for documents that may be required.
Prior to submitting your application, please review and update (if necessary) the information in your candidate profile as it will transfer to your application.
Job Title:
Clinical Financial Case Mgr - RNDepartment:
Health System Shared Services | Revenue Cycle Clinical SupportScope of Position
Revenue Cycle Clinical Support Office (RCCS) is an area within Access and Revenue Cycle Management Shared Services responsible for Clinical Pre-Certification, Case Reviews, Pre-billing edits, in-patient account validations, supporting Utilization Management, Peer to Peer processes, complex billing scenarios, audits (governmental, commercial, compliance, and internal), clinical appeals and denial management. RCCS is integral to the Revenue Cycle and supports cash collection through preventing and appealing denials.
Position Summary
The Clinical Financial Case Manager - RN (CFCM-RN) implements and supports the philosophy, mission, values, standards, policies, and procedures of The Ohio State University Wexner Medical Center. The CFCM-RN functions within the multidisciplinary team to secure complex pre-authorizations and prevent/appeal clinical denials. The job duties require the utilization of clinical knowledge to interpret and apply medical necessity guidelines to determine appropriateness for services provided. The CFCM-RN makes determinations on the appropriate level of care (Inpatient or Observation) based on the ability to read, understand, and interpret documented clinical
information. The role requires CFCM-RNs to become Subject Matter Experts (SME) for assigned payers as well as governmental payer requirements and audits such as RAC, MAC, QIO, etc. The CFCM-RN maintains an awareness of State and National Health care trends, JCAHO, CMS, and third-party payer Utilization Management guidelines.
The Financial aspect of the role involves acquiring knowledge of Managed Care, Scheduling, Financial Counseling, Pre-Certification, Admissions/Discharges/Transfers, Clinical workflows and documentation, Revenue Management, Charge Description Master, Coding (Diagnosis, HCPCS, Revenue Codes, Procedure Codes, Modifiers, etc.), Medical Information Management, Release of Information, Case Management, Utilization Management, Clinical Documentation Improvement, Compliance, Legal, Finance, Transplant workflows, Billing, Follow Up, Cash Posting, and any other areas that maybe needed to complete the tasks. The CFCM-RN must be able to read, understand and interpret a payer remit, denial/remark codes, and expected reimbursement to determine the cost effectiveness of completing an appeal.
The CFCM-RN must be versatile, flexible, and very adaptable to change because the payer rules change constantly. The CFCM-RN must be able to troubleshoot, problem solve, continuously learn, be highly independent, self-motivated and have an elevated level of interpretive skills and the ability to work closely with departments such as Legal, Medical Information Management, Physician groups and the Business Office.
Minimum Qualifications For Hire Required:
- Bachelor’s degree in nursing with current license required.
- Minimum of 2 years clinical care experience, caring for patients, anticipating their needs, and understanding the physician’s
plan of care.
- Experience collaborating with physicians and their designees.
- Strong, proven analytical skills. Ability to make educated decisions.
- Extensive knowledge of clinical operations and patient flow.
- Skilled at synthesizing large volumes of information and concisely communicating either verbally or in writing.
- Proficient in Microsoft Office Products such as: Word, Power Point, Excel, SharePoint, Teams, OneNote, etc.
- Proficient in Adobe Professional Proficient in using email, fax machines, copy machines, internet browsers.
- Proficient at typing
- Proficient in Technology, Computer, and Web applications. Must be able to multitask and move between applications quickly and frequently. Must be able to orientate self to new applications quickly. Must be able to manage complexities of having to work in multiple applications such as IHIS, MS Office products, 3M, and all payer websites/applications.
FUNCTION: Finance
SUB FUNCTION: Clinical Financial Case Management RN
CAREER BAND: Individual Contributor - Specialized
CAREER LEVEL: 2
Additional Information:
Location:
Remote LocationPosition Type:
RegularScheduled Hours:
40Shift:
First ShiftFinal candidates are subject to successful completion of a background check. A drug screen or physical may be required during the post offer process.
Thank you for your interest in positions at The Ohio State University and Wexner Medical Center. Once you have applied, the most updated information on the status of your application can be found by visiting the Candidate Home section of this site. Please view your submitted applications by logging in and reviewing your status. For answers to additional questions please review the frequently asked questions .
The university is an equal opportunity employer, including veterans and disability.
See All 41 Remote Medical Case Manager Jobs
Find roles that match your experience and apply in just a few clicks.
Find JobsRemote Medical Case Manager Job Market
Who's Hiring
- CorVel Corporation20
- Crawford & Company11
- TRISTAR2
- AmTrust Financial2
- Southern Rehab Network2
Top Industries Hiring
- Technology & Software
What Employers Look For
The qualifications that appear most often in remote medical case manager jobs.
- Active registered nurse (RN) or licensed clinical social worker (LCSW) licensure in the state of practice
- Certified Case Manager (CCM) credential or eligibility to sit for the exam within a specified timeframe
- Experience applying InterQual or MCG clinical criteria for utilization review or authorization decisions
- Proficiency with case management platforms such as Facets, QNXT, or Epic care management modules
- Minimum two to three years of clinical experience in a relevant setting such as acute care, managed care, or home health
- Strong knowledge of discharge planning, community resources, and coordination across multidisciplinary care teams
Tips for Your Remote Medical Case Manager Job Search
Apply early to remote roles that fit
Migrate Mate lists remote medical case manager openings from across the U.S. in one place. Search roles that match your license, specialty, and state authorization, then apply directly. Remote postings in this field fill fast, so moving early gives you a real edge.
Show async documentation skills on your resume
Remote employers care deeply about written clinical communication. Highlight your experience with electronic health records, care management platforms like Jiva or HealthEdge, and any roles where you managed caseloads without daily in-person check-ins. Specific platform names signal readiness to work remotely from day one.
Get your CCM certification before you apply
The Certified Case Manager credential is a consistent differentiator for remote roles, where hiring managers can't assess you in person. Many remote employers list it as preferred or required, and holding it shortens the screening process, especially at managed care organizations and large health plans.
Prepare for competency-based remote interviews
Remote medical case manager interviews often include scenario questions about managing a complex patient without in-person access to the care team. Practice walking through how you coordinate across providers by phone and electronic messaging, escalate urgent cases remotely, and document decisions in real time.
Remote Medical Case Manager Jobs: Frequently Asked Questions
How do I get a remote medical case manager job?
Target companies that run distributed care management teams, such as managed care organizations, third-party administrators, and large health insurers with virtual case management programs. Remote employers screen heavily for self-direction, clear written documentation skills, and comfort working asynchronously in electronic health record and case management platforms. Candidates who can show independent caseload management and strong written clinical notes stand out consistently.
Which companies hire remote medical case managers?
Employers currently hiring remote medical case managers include CorVel Corporation, Crawford & Company, and TRISTAR, per current remote listings on Migrate Mate as of November 2026. The bulk of remote openings come from managed care organizations, health insurance carriers, and third-party administrators that run distributed care coordination teams across multiple states.
Can you get a remote medical case manager job with no experience?
Yes, but remote entry-level roles are harder to land because you must work independently from day one without in-person supervision. Smaller telehealth companies and remote disease management firms are more likely to hire new graduates. Showing clinical hours, care coordination coursework, and comfort with electronic documentation tools helps close the experience gap when applying remotely.
Do you need a degree for remote medical case manager jobs?
Usually, yes. Most remote employers require at least an associate or bachelor's degree in nursing, social work, or a related health field, and many prefer or require an RN license or CCM certification. That said, remote employers also weigh demonstrated caseload experience, proficiency with case management software, and a history of working with complex patient populations alongside formal credentials.
Which industries hire the most remote medical case managers?
Most remote medical case manager openings sit in Technology & Software, per current remote listings on Migrate Mate as of November 2026. These sectors hire medical case managers remotely because their care coordination workflows operate across geographies and are built around electronic records, phone, and video rather than in-person contact.
See All 41 Remote Medical Case Manager Jobs
Find roles that match your experience and apply in just a few clicks.
Find Jobs