Remote Medicaid RN Consultant

Introduction to the Role

Are you a compassionate registered nurse with a passion for Medicaid services, case management, and healthcare advocacy? This is your chance to make a lasting impact from the comfort of your own home. As a Remote Medicaid RN Consultant, you'll become a vital part of a team committed to promoting patient equity and supporting underserved communities through thoughtful care coordination, clinical review, and healthcare navigation.

This isn't just a job—it's a mission-driven role where your clinical knowledge meets purpose. From guiding Medicaid members through complex systems to partnering with multidisciplinary teams, you will help deliver thoughtful, ethical healthcare support with dignity and respect.

Company Culture and Core Values

Commitment to Compassion and Inclusion

We believe healing begins with understanding. Our workplace fosters warmth, diversity, and inclusivity in every aspect of our work. We actively celebrate different backgrounds and perspectives, recognizing that the best patient outcomes come from teams that reflect the communities they serve.

Valuing Every Voice

Here, registered nurses aren't just clinicians—they're advocates, educators, and collaborators. You will work within an inclusive workplace where your ideas matter, your growth is a priority, and your identity is respected and valued.

Primary Responsibilities of the Position

Key Duties and Tasks

• Conduct clinical assessments for Medicaid members using evidence-based protocols and regulatory guidelines.
• Evaluate medical necessity, level of care, and treatment plans to ensure compliance with Medicaid standards.
• Coordinate care with multidisciplinary teams including physicians, social workers, and behavioral health providers.
• Provide telephonic outreach to members for case review, support services, and health coaching.
• Document findings in electronic health records with clarity and accuracy
• Participate in virtual team meetings, compliance training, and professional development sessions
• Contribute to Medicaid audits, performance improvement projects, and utilization management reviews
• Offer insights into emerging clinical trends to support policy evolution and program efficiency

Remote Work Environment and Flexibility

Where and How You’ll Work

This is a fully remote role—your office is wherever you are. Whether it's a quiet home office or a sunny kitchen nook, you'll have the flexibility to deliver high-quality care on your terms. As long as you have a secure internet connection and a passion for nursing excellence, you're in the right place.

You’ll be part of a collaborative network of remote professionals who are just a message or Zoom call away. Expect daily interactions with supportive colleagues and supervisors who value empathy, transparency, and teamwork.

Technology and Tools Provided

Digital Resources for Success

To empower your success in this remote position, you'll have access to:

• HIPAA-compliant EHR platforms
• Secure teleconferencing tools for patient interaction
• Medicaid data systems for case tracking
• Clinical guidelines, databases, and AI-assisted decision support tools
• Organizational dashboards to monitor performance and metrics

Our tech stack is designed to enhance your clinical judgment, not replace it. Training and ongoing support are provided to ensure ease of use.

Qualifications and Candidate Profile

Required Credentials and Skills

• Active and unrestricted RN license in the U.S.
• Minimum of 3 years' experience in Medicaid case management, utilization review, or population health
• Proven ability to work independently in a remote environment
• Exceptional communication skills with a strong sense of empathy and professionalism
• Working knowledge of state and federal Medicaid regulations
• Proficiency with EHR systems and telehealth platforms

Preferred Qualifications

• Certified Case Manager (CCM) or equivalent certification
• Bilingual fluency in English and another language
• Previous remote nursing experience
• Familiarity with social determinants of health and community-based care models

Benefits and Compensation Package

What You’ll Receive in Return

We take care of our people so you can take care of others. Here’s a glimpse of what we offer:

• Competitive annual salary of $106,687
• Generous health, dental, and vision benefits
• Paid time off, including mental wellness days
• 401(k) with company match
• Professional development funding
• An inclusive workplace that values diverse team contributions

This is more than a compensation package—it's a commitment to your well-being.

Career Growth and Advancement Opportunities

Build a Future in Healthcare Leadership

Join a company where your voice is heard and your impact is celebrated. From leadership mentorship to cross-functional projects, you’ll be supported in your journey to grow as a healthcare leader. We empower our nurses with the resources they need to expand their skills, innovate processes, and influence policy.

In our diverse team, every nurse is a change-maker. Your ability to guide Medicaid patients through complex systems helps reduce disparities and shape a fairer, healthier future for all.

An Employee Experience That Inspires

A True Story from Our Team

When Jordan, one of our RN consultants, joined our team last year, they shared how previously they felt like just another name on a schedule. Within weeks, they found themselves leading a Medicaid outreach project in their state, coordinating with local health departments and supporting high-risk patients remotely. “It felt amazing,” Jordan said, “to finally work somewhere that sees you as a human being first, a nurse second.”

Stories like Jordan’s aren’t rare here. They’re the standard.

Apply Now and Make a Difference

Your Next Chapter Begins Here

If you’re passionate about equitable healthcare, collaborative work, and the ability to make a difference without the commute, this is your moment.

Apply now to transform care from wherever you are.