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 ...
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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 ...
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Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Registered Nurse - AI Trainer
Washington, DC ยท Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
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Registered Nurse - AI Trainer
Washington, DC ยท Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Quick apply
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 ...
Psychiatric Nurse Practitioner (PMHNP) - Telehealth
Washington, DC ยท Remote
$84 - $115/hr
Flexible & Remote Telemedicine: Evidence-based approach to psychiatric care via telemedicine ... Active and clear APRN license * Licensed Nurse Practitioner - Certified in Psychiatric & Mental ...
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Psychiatric Nurse Practitioner (PMHNP) - Telehealth
Washington, DC ยท Remote
$84 - $115/hr
Flexible & Remote Telemedicine: Evidence-based approach to psychiatric care via telemedicine ... Active and clear APRN license * Licensed Nurse Practitioner - Certified in Psychiatric & Mental ...
Psychiatric Nurse Practitioner (PMHNP) - Telehealth
Millersville, MD ยท Remote
$84 - $115/hr
Flexible & Remote Telemedicine: Evidence-based approach to psychiatric care via telemedicine ... Active and clear APRN license * Licensed Nurse Practitioner - Certified in Psychiatric & Mental ...
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Psychiatric Nurse Practitioner (PMHNP) - Telehealth
Millersville, MD ยท Remote
$84 - $115/hr
Flexible & Remote Telemedicine: Evidence-based approach to psychiatric care via telemedicine ... Active and clear APRN license * Licensed Nurse Practitioner - Certified in Psychiatric & Mental ...
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 ...
Experience with telehealth platforms, remote patient monitoring, and EHR systems is essential. * Licensure/Certification: Current active licensure as a Registered Nurse (RN), Licensed Clinical Social ...
Experience with telehealth platforms, remote patient monitoring, and EHR systems is essential. * Licensure/Certification: Current active licensure as a Registered Nurse (RN), Licensed Clinical Social ...
Registered Nurse - Oncology/Hematology/Infusion Clinic
Washington, DC ยท On-site +1
$83K - $158K/yr
Summary The primary purpose of the Oncology/Hematology Infusion Clinic Registered Nurse position is to demonstrate proficiency in practice based on conscious, deliberate planning and is self-directed ...
Registered Nurse - Oncology/Hematology/Infusion Clinic
Washington, DC ยท On-site +1
$83K - $158K/yr
Summary The primary purpose of the Oncology/Hematology Infusion Clinic Registered Nurse position is to demonstrate proficiency in practice based on conscious, deliberate planning and is self-directed ...
Nurse (Inpatient Clinical/Ob-Gyn)
Bethesda, MD ยท On-site +1
$109K - $142K/yr
Provide perioperative care, including serving as the circulating RN for cesarean sections and additional obstetric surgical procedures as needed (i.e., dilatation and curettage, cervical cerclage ...
Nurse (Inpatient Clinical/Ob-Gyn)
Bethesda, MD ยท On-site +1
$109K - $142K/yr
Provide perioperative care, including serving as the circulating RN for cesarean sections and additional obstetric surgical procedures as needed (i.e., dilatation and curettage, cervical cerclage ...
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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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 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 ...
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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 ...
CCT, CRAT, FMG, RN, LPN, EMT-I or Paramedic (Preferred) * CCT CRAT RN or Paramedic (Preferred) Compensation: This is an hourly role starting at $22 per hour and up, DOE. We pay hourly shift ...
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CCT, CRAT, FMG, RN, LPN, EMT-I or Paramedic (Preferred) * CCT CRAT RN or Paramedic (Preferred) Compensation: This is an hourly role starting at $22 per hour and up, DOE. We pay hourly shift ...
Supervisory Nurse
Washington, DC ยท On-site +1
Supervise Registered Nurses (RNs), Licensed Practical Nurses (LPNs), Certified Nursing Assistants (CNAs), students and external agency personnel, makes assignments in accordance with established ...
Supervisory Nurse
Washington, DC ยท On-site +1
Supervise Registered Nurses (RNs), Licensed Practical Nurses (LPNs), Certified Nursing Assistants (CNAs), students and external agency personnel, makes assignments in accordance with established ...
Holter/Cardiac Technologist
Rockville, MD ยท On-site +1
$22/hr
... RN and LPNs with experience in ECG assessment, evaluation of arrhythmia and a thorough respect for accurate data processing and comprehensive reporting. * A minimum of 1+ years working in a remote ...
Holter/Cardiac Technologist
Rockville, MD ยท On-site +1
$22/hr
... RN and LPNs with experience in ECG assessment, evaluation of arrhythmia and a thorough respect for accurate data processing and comprehensive reporting. * A minimum of 1+ years working in a remote ...
Holter/Cardiac Technologist
Rockville, MD ยท Remote
$22/hr
... RN and LPNs with experience in ECG assessment, evaluation of arrhythmia and a thorough respect for accurate data processing and comprehensive reporting. * A minimum of 1+ years working in a remote ...
Holter/Cardiac Technologist
Rockville, MD ยท Remote
$22/hr
... RN and LPNs with experience in ECG assessment, evaluation of arrhythmia and a thorough respect for accurate data processing and comprehensive reporting. * A minimum of 1+ years working in a remote ...
Quality Perform Spl Sr Clinica
Washington, DC ยท On-site +1
Those fully remote associates residing in states where service is required by contract, law, or ... Registered Nurse (RN) required * 5 years of experience in clinical or service quality improvement ...
Quality Perform Spl Sr Clinica
Washington, DC ยท On-site +1
Those fully remote associates residing in states where service is required by contract, law, or ... Registered Nurse (RN) required * 5 years of experience in clinical or service quality improvement ...
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 22 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