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$42

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How much do remote hca utilization review jobs pay per hour?

As of Sep 1, 2026, the average hourly pay for remote hca utilization review in Baltimore, MD is $42.01, according to ZipRecruiter salary data. Most workers in this role earn between $33.22 and $48.27 per hour, depending on experience, location, and employer.

What is the difference between Remote Hca Utilization Review vs Remote Hca Case Manager?

AspectRemote Hca Utilization ReviewRemote Hca Case Manager
CredentialsTypically requires healthcare-related certifications, such as RN or licensed healthcare professionalOften requires RN, social work, or case management certifications
Work EnvironmentPrimarily reviewing medical necessity and insurance coverage remotelyManaging patient cases, coordinating care, and discharge planning remotely
Employer & Industry UsageUsed by health insurance companies, healthcare providers, and utilization review organizationsEmployed by hospitals, insurance companies, and healthcare organizations

Remote Hca Utilization Review focuses on assessing medical necessity and insurance coverage, while Remote Hca Case Managers handle patient care coordination and discharge planning. Both roles require healthcare credentials and are integral to healthcare management, but they differ in daily responsibilities and focus areas.

How do I get into a remote HCA utilization review?

To become a remote HCA utilization review specialist, candidates typically need a healthcare background such as nursing or medical coding, along with knowledge of insurance policies and medical terminology. Relevant certifications like Certified Professional Coder (CPC) or Certified Medical Reimbursement Specialist (CMRS) can improve job prospects. Employers often require prior experience in medical review or utilization management and proficiency with electronic health record (EHR) systems, with many roles offering flexible or remote schedules.

Is remote HCA utilization review work from home?

Remote HCA utilization review jobs are often performed from home, allowing reviewers to assess healthcare claims and authorizations remotely. These roles typically require familiarity with healthcare software, strong communication skills, and adherence to confidentiality standards. Many employers offer flexible or fully remote schedules for this position.

What are popular job titles related to Remote Hca Utilization Review jobs in Baltimore, MD?

For Remote Hca Utilization Review jobs in Baltimore, MD, the most frequently searched job titles are:

What job categories do people searching Remote Hca Utilization Review jobs in Baltimore, MD look for?

The top searched job categories for Remote Hca Utilization Review jobs in Baltimore, MD are:

Remote Hca Utilization Review jobs near you
Infographic showing various Remote Hca Utilization Review job openings in Baltimore, MD as of August 2026, with employment types broken down into 91% Full Time, and 9% Contract. Highlights an 100% Remote job distribution, with an average salary of $87,387 per year, or $42 per hour.

Utilization Review, RN Flex

University of Maryland Medical System

Towson, MD • Remote

Full-time

Posted 12 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)

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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