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Assistant Remote Utilization Review Jobs in Maryland

First American

Title Assistant (Remote- US)

California, MD · On-site +1

$20.34 - $27.12/hr

The Title Assistant must be able to identify issues that are not readily apparent, determine their ... Conduct detailed review of condominium plans for title insurance purposes, including technical ...

Global Alliant Inc

Clinical Analyst

Baltimore, MD · Remote

Remote JobDuration: Contract / FTE Client: Federal Criteria-Need US citizenshipbecause of federal ... Utilization Management / Utilization Review / Prior Authorization * Clinical or healthcare ...

CareFirst

Clinical Navigator (Remote)

Baltimore, MD · Remote

The ideal candidate will have previous experience performing utilization review within a healthcare ... Follows member benefit contracts to assist with benefit determination. * Makes referrals to other ...

CareFirst

Clinical Navigator (Remote)

Baltimore, MD · Remote

The Clinical Navigator (RN) is responsible for utilization management and concurrent review of ... Follows member benefit contracts to assist with benefit determination. * Makes referrals to other ...

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Assistant Remote Utilization Review information

What is the difference between Assistant Remote Utilization Review vs Utilization Review Nurse?

AspectAssistant Remote Utilization ReviewUtilization Review Nurse
CredentialsTypically requires a nursing license, certification in case management or utilization reviewRegistered Nurse (RN) license, often with additional certifications in case management or utilization review
Work EnvironmentRemote, administrative setting, telehealth or telecommutingRemote or hospital/clinic settings, primarily telehealth or administrative
Employer & IndustryHealth insurance companies, managed care organizations, healthcare providersHospitals, insurance companies, healthcare organizations

Both roles involve reviewing patient cases to determine appropriate care and resource utilization. The Assistant Remote Utilization Review typically supports the process with administrative tasks and basic review, while the Utilization Review Nurse performs more in-depth clinical assessments. Both require nursing credentials and often work remotely within healthcare or insurance industries.

What are the most commonly searched types of Remote Utilization Review jobs in Maryland?

The most popular types of Remote Utilization Review jobs in Maryland are:

What are popular job titles related to Assistant Remote Utilization Review jobs in Maryland?

For Assistant Remote Utilization Review jobs in Maryland, the most frequently searched job titles are:

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The top searched job categories for Assistant Remote Utilization Review jobs in Maryland are:

What cities in Maryland are hiring for Assistant Remote Utilization Review jobs?

Cities in Maryland with the most Assistant Remote Utilization Review job openings:

Assistant Remote Utilization Review jobs near you
Infographic showing various Assistant Remote Utilization Review job openings in Maryland as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, 2% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution.

Utilization Review, RN Flex

University of Maryland Medical System

Towson, MD • Remote

Full-time

Posted 18 days ago

Job description

Job Requirements
  • Weekend only position. 
  • 4 - eight hour weekend shifts a month required. 
  • At least 1 major holiday required.
  • Only serious applicants should apply. 
  • Recent UR / MCG experience.
  • Most of the training will be remote however you will be required to start onsite

A Utilization Review (UR) Nurse is a registered nurse who bridges the gap between healthcare providers and insurance companies. They evaluate patient medical records to ensure treatments, procedures, and hospital stays are clinically necessary, cost-effective, and meet established insurance guidelines.

  • Medical Necessity Reviews: They verify that admissions, surgeries, and treatments are medically necessary by comparing patient charts to standardized, evidence-based guidelines like Milliman Care Guidelines (MCG) or InterQual.
  • Concurrent & Retrospective Reviews: They review ongoing hospital stays (concurrent) to authorize continuing care, and review charts after discharge (retrospective) to prevent claim denials and ensure accurate billing.
  • Insurance Liaison: They act as a go-between, submitting clinical data to insurance companies to secure prior authorizations and ongoing approvals so the hospital gets properly reimbursed.
  • Resource Optimization: They monitor the patient's progress to ensure they are in the appropriate level of care (e.g., observation vs. inpatient) and help coordinate discharges to lower levels of care.

Work Experience

Education

* 4 year/ Bachelor's degree in Nursing (Required)

Combination of relevant education and experience may be considered in lieu of degree.

Master's Degree in Nursing (Preferred)

Experience and Skills

Recent UR / MCG experience.

Required Skills: Strong Verbal Communications Skills, Strong Written Communications Skills, Excel Intermediate Level, PowerPoint - Intermediate Level, MS Word - Intermediate Level, Excellent Organizational Skills


Employment Type: OTHER

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