Baltimore, MD · Remote
$20.50/hr
Medical
Dental
Vision
The Prior Authorization Pharmacy Technician is responsible for supporting members, providers, and pharmacies by processing prior authorization requests for prescription medications while ensuring ...
Quick apply
Baltimore, MD · Remote
$20.50/hr
Medical
Dental
Vision
The Prior Authorization Pharmacy Technician is responsible for supporting members, providers, and pharmacies by processing prior authorization requests for prescription medications while ensuring ...
Baltimore, MD · Remote
Medical
Dental
Vision
Life
Retirement
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Make medical necessity / appropriateness determinations and support prior authorizations . * Use ...
Quick apply
Baltimore, MD · Remote
Medical
Dental
Vision
Life
Retirement
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Make medical necessity / appropriateness determinations and support prior authorizations . * Use ...
Baltimore, MD · Remote
Medical
Dental
Vision
Life
Retirement
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Make medical necessity / appropriateness determinations and support prior authorizations . * Use ...
Quick apply
Baltimore, MD · Remote
Medical
Dental
Vision
Life
Retirement
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Make medical necessity / appropriateness determinations and support prior authorizations . * Use ...
Be Seen First
Join our remote federal oversight team to lead and execute compliance audits for the Programs of ... were authorized, coordinated, and delivered in accordance with participant needs and federal ...
Quick apply
Be Seen First
Join our remote federal oversight team to lead and execute compliance audits for the Programs of ... were authorized, coordinated, and delivered in accordance with participant needs and federal ...
Baltimore, MD · Remote
Medical
Dental
Vision
Life
Retirement
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Make medical necessity / appropriateness determinations and support prior authorizations . * Use ...
Quick apply
Baltimore, MD · Remote
Medical
Dental
Vision
Life
Retirement
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Make medical necessity / appropriateness determinations and support prior authorizations . * Use ...
Be Seen First
Join our remote federal oversight team to lead and execute compliance audits for the Programs of ... were authorized, coordinated, and delivered in accordance with participant needs and federal ...
Quick apply
Be Seen First
Join our remote federal oversight team to lead and execute compliance audits for the Programs of ... were authorized, coordinated, and delivered in accordance with participant needs and federal ...
Baltimore, MD · Remote
Medical
Dental
Vision
Life
Retirement
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Make medical necessity / appropriateness determinations and support prior authorizations . * Use ...
Quick apply
Baltimore, MD · Remote
Medical
Dental
Vision
Life
Retirement
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Make medical necessity / appropriateness determinations and support prior authorizations . * Use ...
Baltimore, MD · Remote
Medical
Dental
Vision
Life
Retirement
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Make medical necessity / appropriateness determinations and support prior authorizations . * Use ...
Quick apply
Baltimore, MD · Remote
Medical
Dental
Vision
Life
Retirement
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Make medical necessity / appropriateness determinations and support prior authorizations . * Use ...
Baltimore, MD · Remote
Medical
Dental
Vision
Life
Retirement
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Make medical necessity / appropriateness determinations and support prior authorizations . * Use ...
Quick apply
Baltimore, MD · Remote
Medical
Dental
Vision
Life
Retirement
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Make medical necessity / appropriateness determinations and support prior authorizations . * Use ...
Baltimore, MD · Remote
Medical
Dental
Vision
Life
Retirement
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Make medical necessity / appropriateness determinations and support prior authorizations . * Use ...
Quick apply
Baltimore, MD · Remote
Medical
Dental
Vision
Life
Retirement
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Make medical necessity / appropriateness determinations and support prior authorizations . * Use ...
Baltimore, MD · Remote
Medical
Dental
Vision
Life
Retirement
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Make medical necessity / appropriateness determinations and support prior authorizations . * Use ...
Quick apply
Baltimore, MD · Remote
Medical
Dental
Vision
Life
Retirement
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Make medical necessity / appropriateness determinations and support prior authorizations . * Use ...
Baltimore, MD · Remote
Medical
Dental
Vision
Life
Retirement
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Make medical necessity / appropriateness determinations and support prior authorizations . * Use ...
Quick apply
Baltimore, MD · Remote
Medical
Dental
Vision
Life
Retirement
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Make medical necessity / appropriateness determinations and support prior authorizations . * Use ...
Baltimore, MD · Remote
Medical
Dental
Vision
Life
Retirement
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Make medical necessity / appropriateness determinations and support prior authorizations . * Use ...
Quick apply
Baltimore, MD · Remote
Medical
Dental
Vision
Life
Retirement
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Make medical necessity / appropriateness determinations and support prior authorizations . * Use ...
Baltimore, MD · On-site +1
$78K - $153K/yr
Medical
Dental
Vision
Life
Retirement
PTO
Not Authorized VA offers a comprehensive total rewards package: VA Nurse Total Rewards Requirements ... prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
New
Baltimore, MD · On-site +1
$78K - $153K/yr
Medical
Dental
Vision
Life
Retirement
PTO
Not Authorized VA offers a comprehensive total rewards package: VA Nurse Total Rewards Requirements ... prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
New
Baltimore, MD · On-site +1
$78K - $153K/yr
Not Authorized. Requirements Help Conditions of employment * U.S. Citizenship; non-citizens may ... prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
New
Baltimore, MD · On-site +1
$78K - $153K/yr
Not Authorized. Requirements Help Conditions of employment * U.S. Citizenship; non-citizens may ... prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
New
Baltimore, MD · Remote
$72/hr
Medical
Dental
Vision
Life
Retirement
Lead Product Owner / Business Integration Lead (Prior Authorization) Location/Work model: 100% Remote (must work Eastern Time core hours ) Type: Contract (~ 7 months , Possible extension ...
Quick apply
Baltimore, MD · Remote
$72/hr
Medical
Dental
Vision
Life
Retirement
Lead Product Owner / Business Integration Lead (Prior Authorization) Location/Work model: 100% Remote (must work Eastern Time core hours ) Type: Contract (~ 7 months , Possible extension ...
Baltimore, MD · Remote
$72/hr
Medical
Dental
Vision
Life
Retirement
Lead Product Owner / Business Integration Lead (Prior Authorization) Location/Work model: 100% Remote (must work Eastern Time core hours ) Type: Contract (~ 7 months , Possible extension ...
Quick apply
Baltimore, MD · Remote
$72/hr
Medical
Dental
Vision
Life
Retirement
Lead Product Owner / Business Integration Lead (Prior Authorization) Location/Work model: 100% Remote (must work Eastern Time core hours ) Type: Contract (~ 7 months , Possible extension ...
Baltimore, MD · Remote
$72/hr
Medical
Dental
Vision
Life
Retirement
Lead Product Owner / Business Integration Lead (Prior Authorization) Location/Work model: 100% Remote (must work Eastern Time core hours ) Type: Contract (~ 7 months , Possible extension ...
Quick apply
Baltimore, MD · Remote
$72/hr
Medical
Dental
Vision
Life
Retirement
Lead Product Owner / Business Integration Lead (Prior Authorization) Location/Work model: 100% Remote (must work Eastern Time core hours ) Type: Contract (~ 7 months , Possible extension ...
Baltimore, MD · Remote
Retirement
PTO
This is a part-time (24 hours/week), primarily remote position for an experienced Registered Nurse ... Prior case management experience, preferably in elder care * Unwavering, passionate commitment to ...
Baltimore, MD · Remote
Retirement
PTO
This is a part-time (24 hours/week), primarily remote position for an experienced Registered Nurse ... Prior case management experience, preferably in elder care * Unwavering, passionate commitment to ...
Role Description This is a part-time hybrid role for a Registered Nurse located in Baltimore, MD, with flexibility for some remote work. The Registered Nurse will be responsible for assessing ...
Quick apply
Role Description This is a part-time hybrid role for a Registered Nurse located in Baltimore, MD, with flexibility for some remote work. The Registered Nurse will be responsible for assessing ...
$7.40 - $13.25
0% of jobs
$13.25 - $19.09
0% of jobs
$19.09 - $24.93
4% of jobs
$24.93 - $30.77
18% of jobs
$31.54 is the 25th percentile. Wages below this are outliers.
$30.77 - $36.61
20% of jobs
The median wage is $39.01 / hr.
$36.61 - $42.45
18% of jobs
$47.71 is the 75th percentile. Wages above this are outliers.
$42.45 - $48.29
16% of jobs
$48.29 - $54.13
10% of jobs
$54.13 - $59.97
6% of jobs
$59.97 - $65.82
4% of jobs
$65.82 - $71.66
3% of jobs
$7
$41
$71
| Aspect | Remote Prior Authorization Rn | Remote Medical Coder |
|---|---|---|
| Credentials | RN license, certification in case management or utilization review | Certification in coding (CPC, CCS), high school diploma or equivalent |
| Work Environment | Healthcare facilities, insurance companies, telehealth | Medical offices, insurance companies, remote coding platforms |
| Industry Usage | Utilization review, patient authorization, insurance approval | Medical record review, billing, coding for insurance claims |
Remote Prior Authorization Rns focus on reviewing patient information to approve treatments, while Remote Medical Coders translate medical records into codes for billing. Both roles require healthcare knowledge but serve different functions within the healthcare industry.
For Remote Prior Authorization Rn jobs in Baltimore, MD, the most frequently searched job titles are:
The top searched job categories for Remote Prior Authorization Rn jobs in Baltimore, MD are:
Cities near Baltimore, MD with the most Remote Prior Authorization Rn job openings:
$20.50/hr
Temporary
Medical, Dental, Vision
Posted 5 days ago
The Prior Authorization Pharmacy Technician is responsible for supporting members, providers, and pharmacies by processing prior authorization requests for prescription medications while ensuring excellent customer service, accuracy, and compliance with regulatory requirements. The Pharmacy Technician will answer inbound calls (up to 80 to 100 calls per day) from providers/members and electronic inquiries related to prior authorizations (PAs) with a high level of professionalism, empathy, and customer service. Demonstrate the ability to accurately capture and verify information provided by prescribers, members, and pharmacies to support timely and compliant medication access decisions. This role involves receiving and reviewing authorization requests via phone, fax, and electronic systems, gathering and verifying clinical information, documenting interactions, evaluating requests against coverage criteria and benefit plans, and collaborating with pharmacists to support coverage determinations. The technician manages a high-volume workload, prioritizes requests based on service level agreements and turnaround times, maintains accurate records, resolves coverage-related issues, and communicates effectively with providers, members, pharmacies, and internal teams to facilitate timely access to medications and positive patient outcomes. This position will take incoming requests for prior authorizations, for formulary and non-formulary medications (this can include Commercial, Part D, High Touch Clients, Community and State cliental, Adherence and Monitoring and Prior Authorization Clinical Appeals), while ensuring a high level of customer service and maximizing productivity. Requests can be received via fax or telephone, from providers' offices and pharmacists. The position provides clinical review for authorizations in keeping with legal and contractual requirements, including but not limited to turn around times (TATs) and service level agreements (SLAs). The technician must provide the information clearly, accurately and in a professional manner. Interactions with callers must be documented per contractual and various regulatory / legal requirements
