Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Clinical Navigator (Remote)
Baltimore, MD ยท 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 ...
Clinical Navigator (Remote)
Baltimore, MD ยท 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 ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Associate Medical Editor - Remote
Baltimore, MD ยท Remote
$85K - $90K/yr
The Associate Medical Editor is a licensed oncology registered nurse, preferably with a master ... This is a fully remote position and can be based anywhere within the U.S. ESSENTIAL FUNCTIONS:
Associate Medical Editor - Remote
Baltimore, MD ยท Remote
$85K - $90K/yr
The Associate Medical Editor is a licensed oncology registered nurse, preferably with a master ... This is a fully remote position and can be based anywhere within the U.S. ESSENTIAL FUNCTIONS:
Bilingual (Spanish/English) Cardiometabolic Specialty Care Advanced Practice Provider
Nottingham, MD ยท On-site +1
$103K - $131K/yr
An active and clear RN and APRN or Physician Assistant license must be maintained while employed at ... no premium #LI-REMOTE The pay range listed for this position is the range the organization ...
Bilingual (Spanish/English) Cardiometabolic Specialty Care Advanced Practice Provider
Nottingham, MD ยท On-site +1
$103K - $131K/yr
An active and clear RN and APRN or Physician Assistant license must be maintained while employed at ... no premium #LI-REMOTE The pay range listed for this position is the range the organization ...
Bilingual (Spanish) Advanced Practice Provider (NP or PA): Cardiology
Nottingham, MD ยท On-site +1
$102K - $132K/yr
This position is a fully remote role and requires working hours in CST, MST, or PST. An active and clear RN and APRN or Physician Assistant license in AL, AZ, GA, IL, OH and/or TX is required at time ...
Bilingual (Spanish) Advanced Practice Provider (NP or PA): Cardiology
Nottingham, MD ยท On-site +1
$102K - $132K/yr
This position is a fully remote role and requires working hours in CST, MST, or PST. An active and clear RN and APRN or Physician Assistant license in AL, AZ, GA, IL, OH and/or TX is required at time ...
Cardiometabolic Specialty Care Advanced Practice Provider
Nottingham, MD ยท On-site +1
$96K - $131K/yr
An active and clear RN and APRN or Physician Assistant license must be maintained while employed at ... no premium #LI-REMOTE The pay range listed for this position is the range the organization ...
Cardiometabolic Specialty Care Advanced Practice Provider
Nottingham, MD ยท On-site +1
$96K - $131K/yr
An active and clear RN and APRN or Physician Assistant license must be maintained while employed at ... no premium #LI-REMOTE The pay range listed for this position is the range the organization ...
Telephonic Case Manager I
Nottingham, MD ยท 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 ...
Telephonic Case Manager I
Nottingham, MD ยท 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 ...
Telephonic Case Manager I
Nottingham, MD ยท 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 ...
Quick apply
Telephonic Case Manager I
Nottingham, MD ยท 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 ...
Licensed Psychologist - Remote
Baltimore, MD ยท 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 ...
Quick apply
Licensed Psychologist - Remote
Baltimore, MD ยท 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 ...
Mental Health Therapist - Remote
Baltimore, MD ยท Remote
$650/wk
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 ...
Quick apply
Mental Health Therapist - Remote
Baltimore, MD ยท Remote
$650/wk
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 ...
Licensed Clinical Social Worker - Remote
Baltimore, MD ยท 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 ...
Quick apply
Licensed Clinical Social Worker - Remote
Baltimore, MD ยท 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 ...
Licensed Mental Health Therapist - Remote
Baltimore, MD ยท 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 ...
Quick apply
Licensed Mental Health Therapist - Remote
Baltimore, MD ยท 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 ...
Licensed Mental Health Counselor - Remote
Baltimore, MD ยท 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 ...
Quick apply
Licensed Mental Health Counselor - Remote
Baltimore, MD ยท 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 ...
Licensed Certified Social Worker - Remote
Baltimore, MD ยท Remote
$650/wk
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 ...
Quick apply
Licensed Certified Social Worker - Remote
Baltimore, MD ยท Remote
$650/wk
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 ...
Licensed Clinical Professional Counselor - Remote
Baltimore, MD ยท 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 ...
Quick apply
Licensed Clinical Professional Counselor - Remote
Baltimore, MD ยท 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 ...
Holistic Health Specialist - Work From Home
Baltimore, MD ยท Remote
$61K - $136K/yr
Registered Nurse (RN) with current, valid, unrestricted license in state of operations * 2 years of ... LI-Remote This is a Remote/Work-From-Home role. Must have an active and unrestricted Compact ...
Holistic Health Specialist - Work From Home
Baltimore, MD ยท Remote
$61K - $136K/yr
Registered Nurse (RN) with current, valid, unrestricted license in state of operations * 2 years of ... LI-Remote This is a Remote/Work-From-Home role. Must have an active and unrestricted Compact ...
Remote Rn information
What are some common challenges remote RNs face and how can they overcome them?
What is the difference between Remote Rn vs Remote Lpn?
| Aspect | Remote Rn | Remote Lpn |
|---|---|---|
| Required Credentials | Registered Nurse (RN) license, BSN often preferred | Licensed Practical Nurse (LPN) license |
| Work Environment | Hospitals, clinics, telehealth platforms | Long-term care, home health, telehealth |
| Employer & Industry Usage | Hospitals, healthcare providers, telehealth companies | Long-term care facilities, home health agencies |
Remote Rns typically hold a registered nurse license and work in hospitals or telehealth settings, providing comprehensive patient care. Remote Lpns, with a practical nurse license, often work in long-term care or home health. While both roles involve remote patient interaction, Rns usually handle more complex cases, whereas Lpns focus on basic patient care tasks.
What are the key skills and qualifications needed to thrive as a Remote RN, and why are they important?
What is the best remote job for a nurse?
How can I make 2000 a week working from home?
How to Become a Remote RN
To become a remote nurse, you need the same training, education, and qualifications that non-remote nurses possess, namely nursing licensure in your state. Some virtual RN roles may also require some period of on-site training to learn procedures. Since your duties include performing patient triage via telephone, webcam, or chat apps, you also need strong technical skills and a high-speed internet connection. Fluency in more than one language is a big plus, as is a strong track record of success in self-directed roles. Additionally, a variety of telehealth certifications are available, and these increase your appeal with potential employers.
How to make 300,000 as a nurse online?
What are Remote RNs?
How to make an extra $2000 a month as a nurse?
Contractor
Medical, Dental, Vision, Life, Retirement
Posted 27 days ago
Job description
Utilization Management Specialist (UM / Utilization Review Nurse) โ Remote
Location: 100% Remote (U.S.) โ Maryland compact/eligibility required Type: Contract (approx. 3 months; potential extension) Schedule: MonโFri, 8:00amโ5:00pm ET (1-hour lunch) - Flex after ramp-up start time between 7:00amโ9:00am ET Pay (W2): USD 51.00/H
Job overview
In this role, youโll use your clinical background and utilization management experience to review requests for care and determine medical necessity, appropriateness, and benefit coverage. Youโll 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 youโll 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) โ 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 Joulรฉ 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