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Remote Kaiser Rn Jobs in Edgewater, MD (NOW HIRING)

CareFirst

Clinical Navigator (Remote)

Baltimore, MD · Remote

The Clinical Navigator (RN) conducts concurrent review of inpatient level of care, managing the timely and smooth transition from inpatient care to home or other levels of care. Utilizing experience ...

Enara Health

Virtual Weight Management MD/DO

Bowie, MD · Remote

$100 - $135/hr

PA/NP Certificate in Obesity Medicine/obesity background/ABOM a plus * Experience with telemedicine and remote care a plus * Positive attitude, encouraging personality, passionate about achieving ...

Enara Health

Virtual Weight Management MD/DO

Bowie, MD · On-site +1

$100 - $135/hr

PA/NP Certificate in Obesity Medicine/obesity background/ABOM a plus * Experience with telemedicine and remote care a plus * Positive attitude, encouraging personality, passionate about achieving ...

BetterHelp

Licensed Psychologist - Remote

Baltimore, MD · Remote

$55 - $70/hr

Work from the comfort of home (fully remote) * Flexible schedule - you set your own hours. * Free ... Also, we are unable to accept substance abuse counselors, school counselors, registered nurses ...

DataAnnotation

RN - AI Trainer

Washington, DC · Remote

$50 - $60/hr

Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...

DataAnnotation

RN - AI Trainer

Baltimore, MD · Remote

$50 - $60/hr

Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...

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Remote Kaiser Rn information

What are the typical daily responsibilities of a Remote Kaiser RN?

As a Remote Kaiser RN, your daily responsibilities typically include conducting virtual patient assessments, providing health education, managing care coordination, and documenting patient interactions in the EHR system. You'll triage patient needs, offer evidence-based guidance, and often collaborate with physicians, pharmacists, and other healthcare specialists via secure digital platforms. The role may also involve following up on test results, arranging referrals, and responding to patient inquiries in a timely manner. Strong organizational skills are important, as you will manage your caseload independently while ensuring adherence to Kaiser's standards and protocols.

What is a Remote Kaiser RN job?

A Remote Kaiser RN job is a nursing position with Kaiser Permanente that allows registered nurses (RNs) to work from home or a remote location. These nurses typically provide virtual patient care, conduct telehealth assessments, offer patient education, and assist with case management. They use electronic health records and telecommunication tools to coordinate care and ensure patients receive necessary support. This role requires an active RN license, clinical experience, and proficiency with technology.

What are the key skills and qualifications needed to thrive in the Remote Kaiser Rn position, and why are they important?

To thrive as a Remote Kaiser RN, you need a valid registered nursing license, strong clinical assessment skills, and experience with telehealth or remote patient care. Familiarity with Kaiser's electronic health record (EHR) systems, HIPAA compliance, and telemedicine technology is usually required. Excellent communication, critical thinking, and time management abilities are vital soft skills for succeeding in a remote setting. These skills ensure you can deliver quality patient care and coordinate effectively with both patients and interdisciplinary care teams from a distance.

What are popular job titles related to Remote Kaiser Rn jobs in Edgewater, MD? For Remote Kaiser Rn jobs in Edgewater, MD, the most frequently searched job titles are:
What job categories do people searching Remote Kaiser Rn jobs in Edgewater, MD look for? The top searched job categories for Remote Kaiser Rn jobs in Edgewater, MD are:
What cities near Edgewater, MD are hiring for Remote Kaiser Rn jobs? Cities near Edgewater, MD with the most Remote Kaiser Rn job openings:
Remote Kaiser Rn jobs near you
Infographic showing various Remote Kaiser Rn job openings in Edgewater, MD as of July 2026, with employment types broken down into 76% Full Time, 12% Part Time, and 12% Contract. Highlights an 100% Remote job distribution.
Utilization Management Specialist

Utilization Management Specialist

System One

Baltimore, MD • Remote

Contractor

Medical, Dental, Vision, Life, Retirement

Posted 22 days ago

Job description

Utilization Management Specialist (UM / Utilization Review Nurse) — Remote

Location: 100% Remote (U.S.) — Maryland compact/eligibility required Type: Contract (approx. 3 months; potential extension) Schedule: Mon–Fri, 8:00am–5:00pm ET (1-hour lunch) - Flex after ramp-up start time between 7:00am–9:00am ET Pay (W2): USD 51.00/H

Job overview

In this role, you’ll use your clinical background and utilization management experience to review requests for care and determine medical necessity, appropriateness, and benefit coverage. You’ll work fully remote and leverage MCG, medical policy, and regulatory guidelines while collaborating with Medical Directors and internal teams to support timely, accurate authorization decisions.

What you’ll do

  • Perform prospective, concurrent, and retrospective utilization reviews (medical + behavioral health).
  • Make medical necessity / appropriateness determinations and support prior authorizations.
  • Use clinical criteria and policy resources daily (including MCG / Milliman Care Guidelines).
  • Review clinical documentation, benefits, and mandates to ensure services align with coverage and guidelines.
  • Research diagnoses/treatments and high-cost services; summarize findings and escalate complex cases to Medical Directors as needed.
  • Collaborate with internal partners and providers to support benefit application and appropriate levels/settings of care.
  • Maintain accurate documentation and protect PHI while managing a busy caseload.

Required qualifications

  • Active RN or LPN license (RN preferred) — Maryland compact/eligibility required
  • 5+ years clinical nursing experience
  • 2+ years care management / utilization management experience
  • MCG experience (required)
  • Experience supporting Commercial/FEP/Medicare lines of business and applying medical policy/regulatory standards
  • Strong critical thinking, written communication, and ability to work independently in a remote setting
  • Comfortable with web-based tools + Microsoft Office (Word/Excel/PowerPoint)
  • Guiding Care and FACETS (required)

Nice to have

  • Critical Care or ER clinical background
  • Experience with LCD/NCD, Medicare guidelines, ASAM, or other authorization criteria sets

System One, and its subsidiaries including Joulé and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.

System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.

#M-1 #LI-AJ1 Ref: #851-Rockville-S1

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