Registered Nurse – Initial Clinical Reviewer (Remote)

About the role

Blue Cross Blue Shield of Arizona is seeking a Registered Nurse to serve as an Initial Clinical Reviewer. This remote position supports the health insurance team by evaluating clinical information and ensuring compliance with privacy and quality standards.

Key responsibilities

• Identify, research, and process clinical inquiries from internal and external customers.
• Resolve and respond to questions with a focus on accuracy, privacy, and regulatory compliance.
• Document findings and recommendations within the health insurance workflow.
• Collaborate with other clinical and claims professionals to maintain high‑quality service.

Required profile

• Minimum 2 years of experience in a clinical setting, health insurance, or related healthcare field.
• Associate’s degree, nursing diploma, or equivalent post‑high‑school certification (LPN).
• Active, unrestricted RN or LPN license in Arizona (or compact state with endorsement).
• Ability to work remotely while residing in Arizona.

Required skills

What we offer

• Hybrid workforce flexibility through the Workability program.
• Opportunities for professional growth within a leading health insurer.
• Supportive remote work environment with occasional onsite meetings as needed.