Senior Clinical Referral Nurse (RN)

Job Description

Location: Remote

We are seeking an experienced Senior Clinical Referral Nurse (RN) to support specialty medication programs and care coordination initiatives in a fully remote environment. This role focuses on reviewing referral cases, collaborating with providers and members, and helping guide treatment setting decisions based on clinical appropriateness and benefit considerations.

This position requires strong clinical experience, independent decision-making, and the ability to manage a case load in a structured, metrics-driven environment.

The ideal candidate is a seasoned RN with experience in specialty medications, managed care, care coordination, or utilization review. You are confident discussing clinical options, understanding benefit considerations, and navigating complex treatment pathways while maintaining a patient-centered approach.

Responsibilities:

• Review and coordinate specialty medication referral cases
• Evaluate clinical and benefit considerations related to infusion or specialty therapies
• Communicate with providers and members regarding treatment setting options
• Assist members in identifying financial support resources when applicable
• Maintain an active case load while meeting program performance goals
• Document case activity accurately within internal systems
• Support clinical review processes and appeals when needed
• Participate in team discussions regarding program outcomes and member satisfaction
• Ensure compliance with healthcare regulations and internal policies

Qualifications:

• Active and unrestricted Registered Nurse (RN) license required
• Bachelor’s degree in Nursing preferred
• Minimum 5 years of clinical experience
• Experience in managed care, specialty pharmacy, care management, or utilization review preferred
• Strong understanding of specialty drug therapies
• Ability to work independently in a fully remote environment
• Excellent communication and documentation skills

Schedule & Work Environment:

• Full-time remote role
• Standard weekday business hours

Salary Range:

The salary range for this position is $74,000 – $118,000 annually ($35.58 – $56.73 per hour), based on experience. 

Interview Process:

Selected candidates will complete an initial screening with TalentLNX followed by interviews with Clinical Program Leadership and Care Management Leadership.

Equal Opportunity Employer: TalentLNX is committed to equal employment opportunity and prohibits discrimination and harassment of any kind. We are dedicated to building a diverse workforce and fostering an inclusive work environment where all employees and candidates are treated with respect and dignity. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, or any other protected status under applicable law. We actively seek to recruit, develop, and retain talented individuals from diverse backgrounds, and we encourage all qualified candidates to apply for our job opportunities.