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Remote Utilization Management Jobs in Maryland (NOW HIRING)

... utilization) to increase output and reduce rework. * Lead change management and adoption for new ... Remote work and more! About MEDHOST: MEDHOST, founded in 1984 and headquartered in Franklin ...

... management of our Regional partners. This is a remote sales opportunity and will cover the West ... utilization, expand market share, and execute data-driven growth strategies. * Lead cross ...

... management of our Regional partners. This is a remote sales opportunity and will cover the West ... utilization, expand market share, and execute data-driven growth strategies. * Lead cross ...

Work with colleagues and managers to implement and proactively manage superior utility CIS ... utilization of assigned resources. * Be a leader in providing subject matter expertise to R&D and ...

... utilization of resources to grow the business and ensure alignment. You will report to the Manager, Territory Sales and will be work remote from your home office and onsite at distributor locations ...

Senior Network Security Engineer

Suitland, MD · Remote

$63 - $82.50/hr

... remote users, certificates, authentication policies, availability, utilization, and user access issues. * Maintain and troubleshoot RSA SecurID Authentication Manager or equivalent MFA services ...

Manage retirement program budgets and administrative expenses. * Analyze plan costs, fee structures, investment expenses, and utilization trends. * Develop reporting and dashboards for executive ...

$116K - $150K/yr

This position is a remote role. About You Join Colliers as a Workplace Planning Strategist, where ... Analyze occupancy, utilization, portfolio, and business data to identify trends and develop ...

$116K - $150K/yr

This position is a remote role. About You Join Colliers as a Workplace Planning Strategist, where ... Analyze occupancy, utilization, portfolio, and business data to identify trends and develop ...

Showing results 21-40

Remote Utilization Management information

How does a remote utilization management professional typically collaborate with healthcare providers and insurance teams?

Remote Utilization Management professionals frequently interact with both healthcare providers and insurance teams through secure digital platforms, phone calls, and virtual meetings. They review patient records, assess the necessity of medical services, and communicate their recommendations or authorization decisions. Effective collaboration requires clear documentation, timely responses, and strong communication skills to ensure that care is both medically appropriate and cost-effective. While the work is often independent, regular coordination with interdisciplinary teams is essential for maintaining high-quality patient outcomes and adhering to regulatory standards.

What are the key skills and qualifications needed to thrive in remote utilization management?

Success as a Remote Utilization Management Nurse requires a registered nursing license, clinical experience, and strong knowledge of medical necessity criteria and insurance guidelines. Familiarity with utilization review software, electronic health records (EHRs), and case management systems is typically necessary. Exceptional communication, critical thinking, and organizational skills help professionals excel in evaluating cases and coordinating with providers remotely. These skills are crucial for ensuring appropriate care, cost-effective resource use, and regulatory compliance in a remote healthcare setting.

What is remote utilization management?

Remote utilization management is a process in which healthcare professionals, such as nurses or case managers, review and assess the necessity, efficiency, and appropriateness of medical services—often from a remote location. These professionals typically work for insurance companies, hospitals, or healthcare organizations to ensure that patients receive the right care while controlling costs. By working remotely, they use electronic health records, phone calls, and other digital tools to collaborate with providers and patients. This role helps improve healthcare quality and cost-effectiveness while allowing employees flexible work arrangements.

What is the difference between Remote Utilization Management vs Remote Case Management?

AspectRemote Utilization ManagementRemote Case Management
CredentialsRN, LPN, or licensed healthcare professionalsRN, LPN, or social workers
Work EnvironmentHealthcare facilities, insurance companies, telehealthHealthcare providers, insurance, community agencies
Industry UsageInsurance, healthcare, telehealthHealthcare, social services, insurance
Primary FocusReviewing medical necessity, authorizationsCoordinating patient care, support services

Remote Utilization Management primarily involves reviewing medical necessity and authorizations, while Remote Case Management focuses on coordinating patient care and support services. Both roles require healthcare credentials and are used within healthcare and insurance industries, but they serve different functions in patient care and resource allocation.

What are the most commonly searched types of Utilization Management jobs in Maryland? The most popular types of Utilization Management jobs in Maryland are:
What cities in Maryland are hiring for Remote Utilization Management jobs? Cities in Maryland with the most Remote Utilization Management job openings:
Infographic showing various Remote Utilization Management job openings in Maryland as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution.

(Remote) Team Lead, Account Follow-Up Services

Harris

Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 19 days ago


Harris Computer rating

8.5

Company rating: 8.5 out of 10

Based on 10 frontline employees who took The Breakroom Quiz

78th of 242 rated software companies


Job description

MEDHOST, a division of Harris; is seeking an Account Follow-Up Services Team Leader who will provide strategic oversight of Hospital Insurance Follow-Up Services, including multi-team performance, payer strategy, denial prevention initiatives, workforce planning, and operational scaling.


This role drives measurable improvement in A/R aging, collections performance, and denial overturn rates through KPI leadership, cross-functional collaboration, training programs, continuous process innovation and adjust priorities on the fly.


This remote role welcomes candidates anywhere in the US. Preference will be given to candidates who can work in CST timezone.


Salary:

60K - 70K


AI & Innovation Mindset

We are committed to leveraging emerging technologies to improve how we work, serve our customers, and drive business outcomes. The successful candidate will demonstrate curiosity and a willingness to actively adopt and leverage AI tools to improve workflows, solve problems, and increase efficiency. Candidates should be comfortable using AI enabled technologies, including copilots, chat based AI assistants, and automation tools, as part of their everyday work while maintaining appropriate judgment, security, and compliance standards.


What your impact will be:

Operational & Performance Leadership

  • Own performance across one or more Insurance Follow-Up teams (or multiple clients).
  • Set daily/weekly/monthly targets for productivity, quality, and collections, ensuring adherence to service-level expectations.
  • Lead KPI governance (Days in A/R, A/R > 90, denial rate, overturn rate, net collection rate, first-pass resolution, productivity per FTE, quality).
  • Build and present performance reviews and executive-ready reporting; drive corrective action plans.

Denials Strategy & Payer Optimization

  • Lead payer trend analysis and root-cause programs to reduce preventable denials (eligibility, auth, coding/modifiers, timely filing, medical necessity, COB).
  • Standardize best practices for appeals, reconsiderations, and payer escalations.
  • Partner with leadership on payer playbooks and escalation pathways; ensure consistent documentation standards.

Training, Enablement & Quality Control

  • Design and maintain scalable training programs, SOPs, and payer-specific job aids.
  • Establish QA frameworks and audit cadence; monitor error trends and implement remediation plans.
  • Develop team leads and high-potential staff through structured coaching and succession planning.

Innovation & Process Improvement

  • Drive workflow optimization through queue design, inventory management, and prioritization strategies.
  • Recommend technology improvements (automation, templates, dashboards, portal utilization) to increase output and reduce rework.
  • Lead change management and adoption for new tools, payer policy updates, and client requirements.

Cross-Functional & Client Partnership

  • Collaborate with coding, payment posting, charge entry, eligibility, and client stakeholders to resolve systemic issues impacting AR.
  • Participate in client performance calls and support recovery plans for at-risk KPIs.

What we are looking for:

  • 3-5+ years of RCM experience with deep Insurance Follow-Up/Denials expertise.
  • 2-4+ years leading teams (supervisor/team lead/manager level).
  • Demonstrated success improving KPI outcomes (A/R aging reduction, denial reductions, increased overturn rate, improved collections).
  • Strong analytics/reporting capability (Excel required; dashboard/reporting tools preferred).
  • Advanced knowledge of payer behavior, denial categories, escalation processes, and appeals best practices.
  • Ability to travel when required to client site.
  • High Speed Internet access (minimum 300 Mbps download speed) and unlimited data.
  • Smart phone for Multi Factor Authentication (MFA) application.
  • Excellent communication skills (verbal & written), good judgement, tact, initiative, and resourcefulness.
  • Must be detail oriented, organized, and ability to multi-task.
  • Ability to demonstrate supportive relationships with peers, clients, partners, and corporate executives.
  • Must be flexible with a "can do" attitude and have the ability to remain professional under high pressure situations.

What we can offer:

  • 3 weeks' vacation and 5 personal days
  • Comprehensive Medical, Dental, and Vision benefits starting from your first day of employment
  • Employee stock ownership and RRSP/401k matching programs
  • Lifestyle rewards
  • Remote work and more!

About MEDHOST:

MEDHOST, founded in 1984 and headquartered in Franklin, Tennessee, is a leading provider of healthcare information technology solutions. Serving over 1,000 healthcare facilities nationwide, MEDHOST offers a comprehensive suite of products, including electronic health records (EHR), financial management systems, and patient engagement platforms. Their mission is to empower healthcare organizations to enhance patient care and improve business operations through innovative, user-friendly solutions. In January 2024, MEDHOST was acquired by N. Harris Computer Corporation, further strengthening its position in the healthcare IT industry.


About Harris:

Harris is a leading provider of mission critical software to the public sector in North America. As a wholly owned subsidiary of Constellation Software Inc. ("CSI", symbol CSU on the TSX), Harris has become the cornerstone for CSI's investment in utility, local government, school districts, public safety, and healthcare software verticals. Our success has been realized through investments in our proprietary software and market expertise. This focus, combined with acquiring businesses that build upon or complement our offerings, has helped drive our success. Harris will continue to growth through reinvestment - both in the people and products that we offer and making investments in acquiring new businesses.


#LI-remote


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About Harris Computer Systems

Sourced by ZipRecruiter

Harris Computer Systems, based in Ottawa, ON, CA, is an established player in the field of public sector software technology. Since its inception in 1976, the company has been striving to make clients' operations more efficient through reliable, practical, and flexible software solutions. Its extensive portfolio primarily serves utility, healthcare, public sector, and educational institutions, contributing to the betterment of public services through technology. Harris strongly believes in the value of forward-thinking technology and the power it has to drive progress for the public sector. This methodology is entirely in line with their mission to ensure customer success by providing reliable, practical, and robust software solutions.

Industry

Accounting services

Company size

1,001 - 5,000 Employees

Headquarters location

Ottawa, ON, CA

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