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Remote Promedica Rn Jobs in Annapolis, 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 ...

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 ...

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Remote Promedica Rn information

What is the difference between Remote Promedica Rn vs Remote Promedica Lpn?

AspectRemote Promedica RnRemote Promedica Lpn
CredentialsRegistered Nurse (RN) licenseLicensed Practical Nurse (LPN) license
Work EnvironmentTelehealth, patient assessments, care planningTelehealth, basic patient care, medication administration
Employer & IndustryHealthcare, hospital systems, telehealth providers

Remote Promedica Rn and Remote Promedica Lpn roles both operate in telehealth settings within the healthcare industry. RNs typically handle more complex patient assessments and care planning, requiring an RN license, while LPNs focus on basic patient care and medication support, requiring an LPN license. Both roles are essential in remote healthcare delivery, but RNs generally have broader responsibilities and higher qualifications.

Are remote Promedica RNs jobs hard to get?

Remote Promedica RNs jobs can be competitive, as they often require relevant nursing experience, licensure, and strong clinical skills. Applicants with certifications such as BLS or ACLS and familiarity with telehealth tools may have an advantage in the hiring process.

What is the best remote job for registered nurses?

A remote registered nurse (RN) can work in roles such as telehealth nurse, case manager, or health coach, which involve providing patient care, education, and support via phone or video consultations. These positions typically require strong communication skills, clinical knowledge, and relevant licensure, often with flexible schedules and the use of electronic health record systems.

What are the most commonly searched types of Promedica Rn jobs in Annapolis, MD?

The most popular types of Promedica Rn jobs in Annapolis, MD are:

What are popular job titles related to Remote Promedica Rn jobs in Annapolis, MD?

For Remote Promedica Rn jobs in Annapolis, MD, the most frequently searched job titles are:

What job categories do people searching Remote Promedica Rn jobs in Annapolis, MD look for?

The top searched job categories for Remote Promedica Rn jobs in Annapolis, MD are:

What cities near Annapolis, MD are hiring for Remote Promedica Rn jobs?

Cities near Annapolis, MD with the most Remote Promedica Rn job openings:

Remote Promedica Rn jobs near you
Infographic showing various Remote Promedica Rn job openings in Annapolis, MD as of August 2026, with employment types broken down into 2% As Needed, 55% Full Time, 17% Part Time, and 26% Contract. Highlights an 98% Physical, and 2% Remote job distribution.

Utilization Management Specialist

System One

Baltimore, MD • Remote

Contractor

Medical, Dental, Vision, Life, Retirement

Re-posted 16 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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