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 ...
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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 ...
Medical Director
Linthicum, MD · On-site +1
$266K - $315K/yr
Round with concurrent review nurses on a regular basis to discuss inpatient members as determined ... Experience in utilization review and management practices, processes, and procedures. * Knowledge ...
Medical Director
Linthicum, MD · On-site +1
$266K - $315K/yr
Round with concurrent review nurses on a regular basis to discuss inpatient members as determined ... Experience in utilization review and management practices, processes, and procedures. * Knowledge ...
Perform clinical reviews (i.e., part A, B, appeals, quality of care) and conduct peer to peer ... Fully remote work #LI-DS1 #LI-Remote The pay range listed for this position is the range the ...
Perform clinical reviews (i.e., part A, B, appeals, quality of care) and conduct peer to peer ... Fully remote work #LI-DS1 #LI-Remote The pay range listed for this position is the range the ...
Care Manager (Remote)
Baltimore, MD · Remote
... Utilization Review, Disease Management or other direct patient care experience. Preferred ... CCM/ACM or other RN Board Certified certification in case management. * Previous experience with ...
Care Manager (Remote)
Baltimore, MD · Remote
... Utilization Review, Disease Management or other direct patient care experience. Preferred ... CCM/ACM or other RN Board Certified certification in case management. * Previous experience with ...
... RN - Registered Nurse in MD, VA or Washington, DC Experience: 5 years clinically related experience working in Care Management, Home Health, Discharge Coordination and/or Utilization Review.
... RN - Registered Nurse in MD, VA or Washington, DC Experience: 5 years clinically related experience working in Care Management, Home Health, Discharge Coordination and/or Utilization Review.
Telephonic Case Manager I - California RN License Required
Nottingham, MD · Remote
$63K - $95K/yr
This is a remote role. California RN license is required for this role. ESSENTIAL FUNCTIONS ... Strong cost containment background, such as utilization review or managed care helpful
Telephonic Case Manager I - California RN License Required
Nottingham, MD · Remote
$63K - $95K/yr
This is a remote role. California RN license is required for this role. ESSENTIAL FUNCTIONS ... Strong cost containment background, such as utilization review or managed care helpful
Telephonic Case Manager I - California RN License Required
Nottingham, MD · Remote
$63K - $95K/yr
This is a remote role. California RN license is required for this role. ESSENTIAL FUNCTIONS ... Strong cost containment background, such as utilization review or managed care helpful
Quick apply
Telephonic Case Manager I - California RN License Required
Nottingham, MD · Remote
$63K - $95K/yr
This is a remote role. California RN license is required for this role. ESSENTIAL FUNCTIONS ... Strong cost containment background, such as utilization review or managed care helpful
Claims Analyst III
Millersville, MD · On-site +1
Remote About J29 J29 is an employee centered healthcare management consulting company that ... utilization review, case management, etc.) 8-11 years preferred. * Must hold a current, active RN ...
New
Claims Analyst III
Millersville, MD · On-site +1
Remote About J29 J29 is an employee centered healthcare management consulting company that ... utilization review, case management, etc.) 8-11 years preferred. * Must hold a current, active RN ...
New
Licensed Clinical Social Worker (LCSW) - Remote Full-Time Position at Desta Care Therapeutic
Baltimore, MD · Remote
$90K - $105K/yr
In this full-time remote role, you will utilize your expertise in mental health to support ... Familiarity with mental health regulations, documentation protocols, and utilization review ...
New
Licensed Clinical Social Worker (LCSW) - Remote Full-Time Position at Desta Care Therapeutic
Baltimore, MD · Remote
$90K - $105K/yr
In this full-time remote role, you will utilize your expertise in mental health to support ... Familiarity with mental health regulations, documentation protocols, and utilization review ...
New
Licensed Clinical Social Worker (LCSW) - Remote Full-Time Position at Desta Care Therapeutic
Baltimore, MD · Remote
$90K - $105K/yr
In this full-time remote role, you will utilize your expertise in mental health to support ... Familiarity with mental health regulations, documentation protocols, and utilization review ...
New
Licensed Clinical Social Worker (LCSW) - Remote Full-Time Position at Desta Care Therapeutic
Baltimore, MD · Remote
$90K - $105K/yr
In this full-time remote role, you will utilize your expertise in mental health to support ... Familiarity with mental health regulations, documentation protocols, and utilization review ...
New
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 ... Strong cost containment background, such as utilization review or managed care helpful
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 ... Strong cost containment background, such as utilization review or managed care helpful
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 ... Strong cost containment background, such as utilization review or managed care helpful
Quick apply
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 ... Strong cost containment background, such as utilization review or managed care helpful
Experience: 3 years of clinically related experience working in Medical Review, Utilization Management, or other RN direct patient care or health insurance payor experience. Preferred Qualifications:
Experience: 3 years of clinically related experience working in Medical Review, Utilization Management, or other RN direct patient care or health insurance payor experience. Preferred Qualifications:
Medical Director II, Utilization Management
Nottingham, MD · On-site +1
$280K - $345K/yr
Perform clinical reviews (i.e., part A, B, appeals, quality of care) and conduct peer to peer ... Comfort with ambiguity and a love for problem solving. #LI-Remote Salary Range: $280,000 - $345,000 ...
Medical Director II, Utilization Management
Nottingham, MD · On-site +1
$280K - $345K/yr
Perform clinical reviews (i.e., part A, B, appeals, quality of care) and conduct peer to peer ... Comfort with ambiguity and a love for problem solving. #LI-Remote Salary Range: $280,000 - $345,000 ...
... and nurse experience, quality and safety, productivity, workload, utilization, and cost ... Remote patient monitoring * Connected care * Clinical informatics * Digital health * Technology ...
... and nurse experience, quality and safety, productivity, workload, utilization, and cost ... Remote patient monitoring * Connected care * Clinical informatics * Digital health * Technology ...
Medical Reviewer, Registered Nurse
Millersville, MD · On-site +1
Remote *This role is a temporary position and that employment is expected to be for a limited ... Our team of 260 employees focuses on providing processing, review, and analysis of medical claims ...
Medical Reviewer, Registered Nurse
Millersville, MD · On-site +1
Remote *This role is a temporary position and that employment is expected to be for a limited ... Our team of 260 employees focuses on providing processing, review, and analysis of medical claims ...
Nurse SME - Contingent
Millersville, MD · On-site +1
$100K - $120K/yr
Remote About J29 J29 is an employee centered healthcare management consulting company that ... Experience conducting clinical audits, medical record reviews, claims reviews, utilization reviews ...
New
Nurse SME - Contingent
Millersville, MD · On-site +1
$100K - $120K/yr
Remote About J29 J29 is an employee centered healthcare management consulting company that ... Experience conducting clinical audits, medical record reviews, claims reviews, utilization reviews ...
New
Licensed Marriage and Family Therapist (LMFT) - Remote Opportunity
White Marsh, MD · Remote
$90K - $110K/yr
This remote setting fosters a healthy work-life balance and allows you to engage with clients from ... Familiarity with mental health care regulations and utilization review processes. * Previous ...
New
Licensed Marriage and Family Therapist (LMFT) - Remote Opportunity
White Marsh, MD · Remote
$90K - $110K/yr
This remote setting fosters a healthy work-life balance and allows you to engage with clients from ... Familiarity with mental health care regulations and utilization review processes. * Previous ...
New
Licensed Marriage and Family Therapist (LMFT) - Remote Opportunity
White Marsh, MD · Remote
$90K - $110K/yr
This remote setting fosters a healthy work-life balance and allows you to engage with clients from ... Familiarity with mental health care regulations and utilization review processes. * Previous ...
New
Licensed Marriage and Family Therapist (LMFT) - Remote Opportunity
White Marsh, MD · Remote
$90K - $110K/yr
This remote setting fosters a healthy work-life balance and allows you to engage with clients from ... Familiarity with mental health care regulations and utilization review processes. * Previous ...
New
Utilization Management Coordinator - Remote / Telecommute
Baltimore, MD · Remote
$19 - $24/hr
Reviews authorization requests for initial determination and/or triages for clinical review and resolution. * Provides general support and coordination services for the department including but not ...
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Utilization Management Coordinator - Remote / Telecommute
Baltimore, MD · Remote
$19 - $24/hr
Reviews authorization requests for initial determination and/or triages for clinical review and resolution. * Provides general support and coordination services for the department including but not ...
Remote Utilization Review Nurse information
See Rosedale, MD salary details
$20.52 - $24.67
2% of jobs
$24.67 - $28.82
9% of jobs
$31.66 is the 25th percentile. Wages below this are outliers.
$28.82 - $32.97
21% of jobs
The median wage is $36.33 / hr.
$32.97 - $37.12
23% of jobs
$37.12 - $41.27
13% of jobs
$44.50 is the 75th percentile. Wages above this are outliers.
$41.27 - $45.42
10% of jobs
$45.42 - $49.57
8% of jobs
$49.57 - $53.72
5% of jobs
$53.72 - $57.87
5% of jobs
$57.87 - $62.02
2% of jobs
$62.02 - $66.17
2% of jobs
$20
$40
$66
How much do remote utilization review nurse jobs pay per hour?
As of Sep 5, 2026, the average hourly pay for remote utilization review nurse in Rosedale, MD is $40.55, according to ZipRecruiter salary data. Most workers in this role earn between $32.07 and $46.59 per hour, depending on experience, location, and employer.
What is a remote utilization review nurse?
A Remote Utilization Review Nurse is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services and treatments, typically from a remote location such as their home. They review patient medical records, apply clinical guidelines, and collaborate with providers and insurance companies to ensure patients receive appropriate care while managing healthcare costs. This role often involves making coverage determinations, conducting pre-authorizations, and participating in appeals processes. Remote Utilization Review Nurses play a critical role in improving patient outcomes and resource allocation within the healthcare system.
What does a remote utilization review nurse do?
As a remote utilization nurse, your duties are to work from home or a remote location to review patient medical records and prepare a range of paperwork for different types of actions a hospital or health care provider can take. Your responsibilities are to determine patient coverage, carry out denial of service authorizations, and negotiate different treatment options and hospital stay length for patients. You rely on your knowledge of treatment options and diseases to determine the level of appropriate care for a patient. Because you telecommute, you also need good technical skills.
What are the key skills and qualifications needed to thrive as a remote utilization review nurse?
To thrive as a Remote Utilization Review Nurse, you need a current RN license, clinical experience, and a solid understanding of medical necessity criteria and healthcare regulations. Familiarity with utilization management software, EHR systems, and certifications like CCM or URAC are highly valued. Strong analytical thinking, attention to detail, and effective communication skills enable success in evaluating clinical documentation and collaborating with providers remotely. These skills and qualifications are essential to ensure efficient, compliant care decisions that optimize patient outcomes and resource use.
How does a remote utilization review nurse collaborate with physicians and other healthcare team members while working remotely?
As a Remote Utilization Review Nurse, collaboration with physicians, case managers, and other healthcare professionals is primarily conducted through secure digital platforms such as email, video conferencing, and electronic health record systems. Effective communication is essential to discuss patient care plans, clarify medical necessity, and ensure compliance with utilization policies. Nurses in this role often participate in virtual meetings or case conferences to present findings and recommendations. Building strong working relationships remotely requires proactive communication, responsiveness, and familiarity with digital collaboration tools.
What is the difference between Remote Utilization Review Nurse vs Remote Case Manager?
| Aspect | Remote Utilization Review Nurse | Remote Case Manager |
|---|---|---|
| Certifications | RN license, possibly CCM or UR certifications | RN license, CCM or case management certifications |
| Work Environment | Healthcare facilities, insurance companies, telehealth | Insurance companies, healthcare organizations, telehealth |
| Job Focus | Review medical necessity, approve or deny services | Coordinate patient care, arrange services, discharge planning |
Remote Utilization Review Nurses primarily evaluate medical necessity for services, while Remote Case Managers coordinate patient care and discharge planning. Both roles require nursing credentials and work in healthcare or insurance settings, but their core responsibilities differ. Understanding these distinctions helps job seekers find the best fit for their skills and career goals.
More about Remote Utilization Review Nurse jobs
What are the most commonly searched types of Utilization Review Nurse jobs in Rosedale, MD?
The most popular types of Utilization Review Nurse jobs in Rosedale, MD are:
What are popular job titles related to Remote Utilization Review Nurse jobs in Rosedale, MD?
For Remote Utilization Review Nurse jobs in Rosedale, MD, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Nurse jobs in Rosedale, MD look for?
The top searched job categories for Remote Utilization Review Nurse jobs in Rosedale, MD are:
What cities near Rosedale, MD are hiring for Remote Utilization Review Nurse jobs?
Cities near Rosedale, MD with the most Remote Utilization Review Nurse job openings:
Job description
Job Title: Clinical Analyst
Job Location: Remote
Job Duration: Contract / FTE
Client: Federal
Criteria- Need US citizenship because of federal regulations and the sensitive nature of the work involved.
Ability to obtain Public Trust Clearance
Must-have skills
- US Healthcare / US Payer / Provider experience
- Utilization Management / Utilization Review / Prior Authorization
- Clinical or healthcare educational background
- ICD-10, CPT, HCPCS
- Claims, denials, billing or medical-necessity review
- Provider communication / provider calls
- Healthcare policy research and interpretation
- Case investigation / issue resolution
- Excel and reporting
- SOP/process documentation
- Strong written and verbal communication
- Able to work 8 AM–6 PM EST coverage
About Global Alliant
Sourced by ZipRecruiter
Global Alliant is an Innovative and Award winning Information Technology and Software Development Company based in Maryland. We partner with clients to transform their complex and mission critical business challenges using Digital Transformation, Cloud Modernization, Agile Engineering, and Process Automation Solutions. Our core capabilities reach across Public Sectors composed of Federal, State, and Local Government Agencies, and deliver the Best in Class Solutions. Global Alliant understands rapid policy changes to bring suitable program and delivery oversight coupled with technical subject matter expertise to not only meet but exceed client expectations.
Industry
It services
Company size
51 - 200 Employees
Headquarters location
Columbia, MD, US
Year founded
2016