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Remote Utilization Review Rn Jobs in Maryland (NOW HIRING)

Physician Auditor

Millersville, MD ยท On-site +1

$189K - $238K/yr

Remote Type: Part-Time *This position is contingent upon the successful award of the associated ... Minimum Requirements: * 10+ years clinical practice; experience in peer review, utilization review ...

Deploys Remote Patient Monitoring and Patient Self Reporting for High-Risk Chronic Conditions ... The RN will establish the business strategy and roadmap: (1) improve outcomes for Grace at Home ...

Deploys Remote Patient Monitoring and Patient Self Reporting for High-Risk Chronic Conditions ... The RN will establish the business strategy and roadmap: (1) improve outcomes for Grace at Home ...

Deploys Remote Patient Monitoring and Patient Self Reporting for High-Risk Chronic Conditions ... The RN will establish the business strategy and roadmap: (1) improve outcomes for Grace at Home ...

Appeals Pharmacist (Remote)

Pasadena, MD ยท On-site +1

$58.25 - $70.75/hr

Collaborate with physicians, nurses, and medical directors during case reviews. * Track, document ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

Appeals Pharmacist (Remote)

Silver Spring, MD ยท On-site +1

$59 - $72/hr

Collaborate with physicians, nurses, and medical directors during case reviews. * Track, document ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

RN Care Manager, Care Transitions

Rockville, MD ยท On-site +1

$94K - $115K/yr

... pre-visit chart prep: review discharge summaries, HIE data, and medical records to identify ... Hybrid - primarily remote with in-person visits when clinically indicated Schedule: Monday-Friday ...

Post-Acute UM Supervisor

Nottingham, MD ยท On-site +1

$95K - $120K/yr

... RN license with a minimum of 4 years of clinical experience * At least 3 years of utilization ... Remote Salary Ragne: $95,000-$120,000 The pay range listed for this position is the range the ...

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Remote Utilization Review Rn information

See Maryland salary details

$20

$41

$66

How much do remote utilization review rn jobs pay per hour?

As of Jun 16, 2026, the average hourly pay for remote utilization review rn in Maryland is $41.04, according to ZipRecruiter salary data. Most workers in this role earn between $32.45 and $47.12 per hour, depending on experience, location, and employer.

What is the meaning of the word remote?

In the context of a Remote Utilization Review RN job, 'remote' refers to working outside of a traditional office setting, often from home or another location of the employee's choice. This setup typically involves using digital tools and communication platforms to perform job duties without being physically present in an office environment.

What are the key skills and qualifications needed to thrive as a Remote Utilization Review RN, and why are they important?

To excel as a Remote Utilization Review RN, you need a valid RN license, strong clinical judgment, and knowledge of utilization management principles. Familiarity with electronic medical records (EMR), utilization management software, and guidelines such as InterQual or MCG is typically required. Outstanding attention to detail, critical thinking, and effective communication skills help you collaborate with healthcare teams and advocate for appropriate patient care. These competencies are crucial for ensuring medical necessity, regulatory compliance, and optimal resource use in a remote setting.

What is a Remote Utilization Review RN?

A Remote Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services provided to patients, typically working from a remote location. They review medical records, apply clinical guidelines, and collaborate with healthcare providers to ensure patients receive the right care at the right time. Their work helps manage healthcare costs and improves patient outcomes by preventing unnecessary treatments or hospital stays. Remote Utilization Review RNs often work for insurance companies, hospitals, or healthcare organizations, and use secure digital platforms to conduct their reviews.

What is the meaning of remote in one word?

In the context of a Remote Utilization Review RN role, 'remote' means working from a location outside of a traditional office, typically from home, using digital communication tools. It emphasizes flexibility and virtual access to work systems without physical presence at a healthcare facility.

What is the difference between Remote Utilization Review Rn vs Remote Case Manager Rn?

AspectRemote Utilization Review RnRemote Case Manager Rn
CertificationsRN license, Utilization Review certification (e.g., URAC)RN license, Case Management certification (e.g., CCM)
Work EnvironmentReviewing medical records, insurance policies, telehealth platformsCoordinating patient care, discharge planning, telehealth
Employer & IndustryInsurance companies, healthcare organizationsHospitals, insurance providers, healthcare agencies

Remote Utilization Review Rns primarily focus on evaluating medical necessity for insurance coverage, while Remote Case Manager Rns coordinate patient care and discharge planning. Both roles require RN licensure and involve telehealth work, but they serve different functions within healthcare and insurance industries.

How to make 2000 a week working from home?

A Remote Utilization Review RN can potentially earn $2,000 weekly by working full-time hours, often 40 hours per week, and gaining experience or certifications that allow for higher billing rates. Increasing income may involve taking on additional cases, specializing in high-demand areas, or working for agencies that offer competitive pay for remote utilization review roles.

What is remote job?

A remote Utilization Review RN job is a healthcare position where the nurse reviews patient cases and insurance claims from a location outside of a traditional office, often working from home. It requires strong communication skills, knowledge of medical documentation, and familiarity with electronic health record systems, with flexible schedules common in remote roles.

What are some common challenges Remote Utilization Review RNs face when working from home, and how can they be addressed?

Remote Utilization Review RNs often encounter challenges such as maintaining clear communication with interdisciplinary teams, managing time efficiently, and staying updated on changing payer guidelines. To address these challenges, it's important to establish consistent check-ins with team members via video or chat platforms, use digital tools to organize and prioritize caseloads, and participate in ongoing training sessions provided by employers. Adhering to a structured daily routine and leveraging available technology can help ensure productivity and high-quality reviews while working remotely.
What cities in Maryland are hiring for Remote Utilization Review Rn jobs? Cities in Maryland with the most Remote Utilization Review Rn job openings:
Physician Auditor

Physician Auditor

J29 Inc.

Millersville, MD โ€ข On-site, Remote

$189K - $238K/yr

Part-time

Posted 7 days ago


Job description

Position: Physician Auditor - Contingent
Location: Remote
Type: Part-Time
*This position is contingent upon the successful award of the associated contract. Employment is not guaranteed until the contract is awarded, and the position is officially activated. Job responsibilities and requirements are subject to change.
About J29
J29 is an employee centered healthcare management consulting company that specializes in processing, reviewing, and analyzing medical claims, records, disputes, and audits. Established in 2017, J29 prides itself on its employee centric culture and high employee retention rates that allow us to ensure that we are creating a working environment that prioritizes the employee experience. Our team brings corporate performance that stretches to various areas where we can provide our clinical, healthcare policy, and compliance expertise through our support to health and human service programs at the State, Federal, and Commercial levels.
Responsibilities:
  • Perform blinded Independent Review (IRR) clinical evaluations, assessing medical necessity, appropriateness of care, and adherence to Medicare guidelines.
  • Collaborate in the development of rebuttals and contribute to informed escalation decisions as needed.
Minimum Requirements:
  • 10+ years clinical practice; experience in peer review, utilization review, or appeals
  • Familiarity with CMS/QIO processes preferred.
  • Licensed MD or DO in the U.S.; active, unrestricted license required.
J29, Inc. is committed to hiring and retaining a diverse workforce. We are proud to be an Equal Opportunity/Affirmative Action Employer, making decisions without regard to race, color, religion, creed, sex, sexual orientation, gender identity, marital status, national origin, age, veteran status, disability, or any other protected class. J29, Inc. is a proud Veteran friendly employer.

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About J29

Sourced by ZipRecruiter

Industry

Business management consulting

Company size

1 - 10 Employees

Headquarters location

Millersville, MD, US

Year founded

2017