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Remote Rn Government 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) 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.

Corvel

Telephonic Case Manager I

Nottingham, MD · Remote

$63K - $95K/yr

This is a remote role. This position requires a California RN Nursing License. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Provide medical case management to individuals through coordination with the ...

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 ...

Maryland Physicians Care

Care Manager

Linthicum, MD · On-site +1

$88K - $97K/yr

Current, unrestricted Registered Nurse license to practice in Maryland. * 2+ years of clinical ... Knowledge of government-sponsored managed care programs is preferred. * BSN preferred . * CCM ...

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Remote Rn Government information

What is a Remote RN Government?

A Remote RN Government job is a nursing position that allows registered nurses to work from home or a remote location while serving government agencies. Responsibilities may include telehealth services, case management, utilization review, or public health initiatives. These roles typically support federal, state, or local government healthcare programs such as Veterans Affairs, Medicaid, or public health departments. Remote RNs use technology to assess, educate, and support patients while ensuring compliance with government healthcare regulations.

What does a Remote RN Government do?

Remote RN Government positions often involve supporting diverse patient populations, such as veterans, underserved communities, or individuals enrolled in public health programs. Daily duties include conducting virtual patient assessments, coordinating care plans, providing health education, and ensuring adherence to government health policies. RNs may also collaborate with case managers, social workers, and public health officials remotely. This role demands the ability to manage a varied caseload efficiently while maintaining thorough documentation and clear communication with patients and colleagues.

What are the key skills and qualifications needed for a Remote RN Government?

To thrive as a Remote RN Government, you need an active registered nurse license, thorough clinical knowledge, and experience working within government regulations or public health frameworks. Familiarity with government healthcare systems, secure telemedicine platforms, and compliance standards (such as HIPAA) is essential. Strong self-motivation, clear communication, and time management skills are vital for working independently while collaborating virtually with multidisciplinary teams. These competencies ensure high-quality patient care, regulatory compliance, and effective remote collaboration in a government healthcare setting.

What are popular job titles related to Remote Rn Government jobs in Baltimore, MD?

For Remote Rn Government jobs in Baltimore, MD, the most frequently searched job titles are:

What job categories do people searching Remote Rn Government jobs in Baltimore, MD look for?

The top searched job categories for Remote Rn Government jobs in Baltimore, MD are:

What cities near Baltimore, MD are hiring for Remote Rn Government jobs?

Cities near Baltimore, MD with the most Remote Rn Government job openings:

Remote Rn Government jobs near you
Infographic showing various Remote Rn Government job openings in Baltimore, MD as of August 2026, with employment types broken down into 10% As Needed, 70% Full Time, and 20% Contract. Highlights an 100% Remote job distribution.

Utilization Management Specialist

System One

Baltimore, MD • Remote

Contractor

Medical, Dental, Vision, Life, Retirement

Re-posted 15 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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