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Remote Phone Rn Jobs in Baltimore, 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 ...

CareFirst

Clinical Navigator (Remote)

Baltimore, MD · Remote

The Clinical Navigator (RN) is responsible for utilization management and concurrent review of inpatient care to ensure members receive medically necessary services at the appropriate level of care.

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 ...

RELI GROUP INC

Medical Review Nurse III

Baltimore, MD · Remote

Registered Nurse, with a current unobstructed license to practice nursing in the United States ... Ability to work well in a remote team environment, to collaborate with others, and interface with ...

RELI Group Inc.

Medical Review Nurse III

Baltimore, MD · On-site +1

$80K - $95K/yr

Registered Nurse, with a current unobstructed license to practice nursing in the United States ... Ability to work well in a remote team environment, to collaborate with others, and interface with ...

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All JobsPhone Rn JobsRemote Phone Rn JobsRemote Phone Rn Jobs in Baltimore, MD

Remote Phone Rn information

See Baltimore, MD salary details

$955

$1.9K

$3K

How much do remote phone rn jobs pay per week?

As of Sep 9, 2026, the average weekly pay for remote phone rn in Baltimore, MD is $1,943.65, according to ZipRecruiter salary data. Most workers in this role earn between $1,519.23 and $2,273.08 per week, depending on experience, location, and employer.

What is the difference between Remote Phone Rn vs Remote Medical Assistant?

AspectRemote Phone RnRemote Medical Assistant
CredentialsRegistered Nurse (RN) licenseCertified Medical Assistant (CMA) or similar certification
Work EnvironmentRemote, telehealth settingsRemote or clinical, administrative support
Industry UsageHealthcare, telehealth servicesHealthcare, clinics, administrative roles
Common Search/ComparisonYesYes

The Remote Phone Rn primarily provides nursing advice and patient support via phone in telehealth settings, requiring an RN license. In contrast, Remote Medical Assistants handle administrative tasks and basic patient support, often with CMA certification. Both roles are remote and serve the healthcare industry, but the RN role involves clinical decision-making, while the Medical Assistant focuses on administrative and support functions.

Remote Phone Rn jobs near you

Utilization Management Specialist

Baltimore, MD • Remote

System One
Business Consulting Services • 5 - 10K employees
Learn more about System Oneexternal

Contractor

Medical, Dental, Vision, Life, Retirement

Re-posted 18 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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About System One

Sourced by ZipRecruiter

System One helps employers get work done more efficiently and economically without compromising quality. Over our 35+ year history, we've helped connect thousands of talented people with innovative companies. The excitement of a perfect fit motivates us every single day.

Industry

Business consulting services and recruiting and staffing services

Company size

5,001 - 10,000 Employees

Headquarters location

Pittsburgh, PA, US

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