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Remote Utilization Management Jobs in Baltimore, MD

Global Alliant Inc

Clinical Analyst

Baltimore, MD · Remote

Remote Job Duration: Contract / FTE Client: Federal Criteria- Need US citizenship because of ... Utilization Management / Utilization Review / Prior Authorization * Clinical or healthcare ...

Global Alliant Inc

Clinical Analyst

Baltimore, MD · Remote

Remote JobDuration: Contract / FTE Client: Federal Criteria-Need US citizenshipbecause of federal ... Utilization Management / Utilization Review / Prior Authorization * Clinical or healthcare ...

Bcbsa

Director, Trade Client Relations

Baltimore, MD · On-site +1

$155K - $175K/yr

... and utilization management strategies * Client Relations - Serve as Trade's primary point of ... Work is generally performed in a remote setting. #LI-Remote $155,000.00 - $175,000.00 This is the ...

System One

Lead Healthcare Product Owner

Baltimore, MD · Remote

$72/hr

... Remote (must work Eastern Time core hours ) Type: Contract (~ 7 months , Possible extension ... utilization management / PA programs . * 8-10+ years operating as a Product Owner (or equivalent ...

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All JobsUtilization Management JobsRemote Utilization Management JobsRemote Utilization Management Jobs in Baltimore, MD

Remote Utilization Management information

See Baltimore, MD salary details

$21

$42

$68

How much do remote utilization management jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for remote utilization management in Baltimore, MD is $42.01, according to ZipRecruiter salary data. Most workers in this role earn between $33.22 and $48.27 per hour, depending on experience, location, and employer.

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 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.

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 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 Baltimore, MD?

The most popular types of Utilization Management jobs in Baltimore, MD are:

What are popular job titles related to Remote Utilization Management jobs in Baltimore, MD?

For Remote Utilization Management jobs in Baltimore, MD, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Management jobs in Baltimore, MD look for?

The top searched job categories for Remote Utilization Management jobs in Baltimore, MD are:

What cities near Baltimore, MD are hiring for Remote Utilization Management jobs?

Cities near Baltimore, MD with the most Remote Utilization Management job openings:

Remote Utilization Management jobs near you
Infographic showing various Remote Utilization Management job openings in Baltimore, MD as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 86% Physical, 3% Hybrid, and 11% Remote job distribution, with an average salary of $87,387 per year, or $42 per hour.

Utilization Management Specialist

CYNET SYSTEMS

Baltimore, MD • Remote

$19 - $24/hr

Contractor

Re-posted 6 days ago

Job description

Job Overview:

Pay Range: $19.66hr - $24.66hr

Requirement/Must Have:

  • 5+ years Clinical nursing experience.
  • 2+ years Care Management.
  • Bachelor's Degree in Nursing.

Responsibilities:

  • Determines medical necessity and appropriateness by referencing regulatory mandates, contracts, benefit information, Milliman Care Guidelines, Apollo Guidelines, ASAM, Medicare Guidelines, Federal Employee Program and Policy Guidelines, Medical Policy, and other accepted medical/pharmaceutical references.
  • Conducts research and analysis of pertinent diseases, treatments and emerging technologies, including high cost/high dollar services to support decisions and recommendations made to the medical directors.
  • Makes appropriate referrals and contacts as appropriate. Offers assistance to members and providers for alternative settings for care.

Nice to Have:

  • Working knowledge of managed care and health delivery systems.
  • Thorough knowledge of clinical guidelines, medical policies and accreditation and regulatory standards.
  • Working knowledge of IT and Medical Management systems.

Skills:

  • Effective written and interpersonal communication skills.
  • Strong assessment skills with the ability to make rapid connection with members.
  • Ability to work effectively with large amounts of confidential member data and PHI.
  • Ability to multitask, prioritize and maintain a dynamic personal organization system.
  • Proficient in the use of web-based technology and Microsoft Office applications.

Qualification And Education:

  • RN - Registered Nurse - State Licensure And/or Compact State Licensure Upon Hire.
  • LPN - Licensed Practical Nurse - State Licensure.
  • CNS - Clinical Nurse Specialist Preferred.

Founded in 2010 and headquartered in the Washington, DC metro area, Cynet Systems Inc. is a leading staffing and recruiting powerhouse. Proudly recognized as a nationally and locally certified diversity firm, Cynet delivers agile, scalable talent solutions across industries. With an active footprint in all 50 U.S. states and Canada, we support thousands of consultants through our expansive, high-performing recruitment engine operating across North America and Asia—ensuring speed, quality, and consistency in every hire.
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About Cynet Systems

Sourced by ZipRecruiter

Cynet Systems Inc is a staffing and recruiting corporation nestled in Ashburn, VA, USA. Established in 2010, the company operates within the Information Technology and Services sector, specializing in providing effective workforce solutions to different business needs, including IT consulting, direct hire, and contract staffing services. Through the years, Cynet Systems has built an impressive portfolio, going beyond borders and expanding its operations internationally in Canada and India. Rooted in its core values of teamwork, leadership, and commitment, Cynet Systems helps businesses unlock their full potential by providing versatile and competent professionals that perfectly align with their needs. Fueled by their unwavering mission to deliver top-tier talent to businesses worldwide, Cynet Systems garnered various recognitions including SIA's fastest-growing staffing firms and Best Place to Work in Virginia for 2019.

Industry

It services

Company size

501 - 1,000 Employees

Headquarters location

Sterling, VA, US

Year founded

2010

Social media

Twitter

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