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Remote Utilization Review Rn Jobs in Halethorpe, MD

Pair Team

Medicare Nurse Practitioner (Remote)

Columbia, MD · Remote

$115K - $130K/yr

Partner with RNs, Community Health Workers, and clinical leadership to close care gaps and ensure ... Our team regularly reviews applications and will reach out to candidates whose qualifications align ...

Varsity Tutors

NCLEX-RN Tutor

Baltimore, MD · Remote

$40/hr

Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates preparing for registered nurse ...

Varsity Tutors

NCLEX-RN Tutor

Laurel, MD · Remote

$40/hr

Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates preparing for registered nurse ...

Varsity Tutors

NCLEX-RN Tutor

College Park, MD · Remote

$40/hr

Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates preparing for registered nurse ...

Varsity Tutors

NCLEX-RN Tutor

Bowie, MD · Remote

$40/hr

Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates preparing for registered nurse ...

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Remote Utilization Review Rn information

See Halethorpe, MD salary details

$20

$41

$67

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

As of Jun 10, 2026, the average hourly pay for remote utilization review rn in Halethorpe, MD is $41.30, according to ZipRecruiter salary data. Most workers in this role earn between $32.64 and $47.40 per hour, depending on experience, location, and employer.

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 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.

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 are popular job titles related to Remote Utilization Review Rn jobs in Halethorpe, MD? For Remote Utilization Review Rn jobs in Halethorpe, MD, the most frequently searched job titles are:
What cities near Halethorpe, MD are hiring for Remote Utilization Review Rn jobs? Cities near Halethorpe, MD with the most Remote Utilization Review Rn job openings:
Remote Utilization Review Rn jobs near you
Infographic showing various Remote Utilization Review Rn job openings in Halethorpe, MD as of June 2026, with employment types broken down into 14% As Needed, 43% Full Time, 29% Part Time, and 14% Temporary. Highlights an 100% Remote job distribution, with an average salary of $85,897 per year, or $41.3 per hour.

Clinical Quality Registered Nurse

Porter Cares, Inc.

Baltimore, MD • Remote

$80K - $85K/yr

Full-time

Posted 21 days ago

Job description

Registered Nurse, Quality Assurance - In-Home Clinical Services 

The candidate must reside in the Greater Baltimore area and be willing to travel throughout the state of MD.

Position Summary 

The Registered Nurse, Quality Assurance is responsible for driving the clinical quality and consistency of practitioners who perform in-home assessments, laboratory tests, and diagnostic services across the member's home or any alternate location where services are delivered. This role combines clinical oversight, data-driven performance analysis, and direct coaching to ensure every encounter meets evidence-based standards, regulatory requirements, and the organization's quality benchmarks. The RN Quality Assurance partner serves as both an auditor and an educator - translating quality data into actionable feedback that elevates practitioner performance and improves member outcomes. 

Key Responsibilities 

Quality Oversight & Auditing 

  • Conduct routine and targeted audits of in-home assessments, lab specimen collection, and diagnostic procedures performed by field practitioners (NPs, RNs and LPNs 

  • Review documentation, chart notes, and encounter data for completeness, clinical accuracy, and adherence to protocols. 

  • Perform ride-along and virtual observation visits to assess clinical technique, member interaction, infection control, and specimen handling. 

  • Identify deviations from clinical standards and document findings in the quality management system. 

Data Analysis & Reporting 

  • Analyze quality metrics, audit results, lab rejection rates, redraw rates, and member-experience data to identify trends and root causes. 

  • Build and maintain dashboards and reports that surface practitioner-level and program-level performance to operations and clinical leadership. 

  • Translate quantitative findings into prioritized improvement opportunities with measurable targets. 

  • Partner with data and analytics teams to refine quality measures and benchmarks over time. 

Coaching, Education & Practitioner Development 

  • Deliver one-on-one feedback and coaching to practitioners based on audit findings, with clear expectations and follow-up. 

  • Design and assist in training sessions, in-services, and competency assessments covering clinical procedures, documentation, and member experience. 

  • Develop job aids, SOPs, and reference materials that codify best practices for in-home and alternate-site service delivery. 

  • Mentor new hires through onboarding and validate clinical competency before independent practice. 

Compliance & Continuous Improvement 

  • Ensure practitioner activities comply with CLIA, OSHA, HIPAA, state nursing scope-of-practice rules. 

  • Investigate clinical incidents, near misses, and member complaints; document findings and recommend corrective action. 

  • Collaborate with Operations to close gaps and operationalize new clinical workflows. 

Required Qualifications 

  • Active, unrestricted Registered Nurse (RN) license in the state of residence; willingness to obtain additional state licensure or compact privileges as required. 

  • Bachelor of Science in Nursing (BSN) required; advanced degree (MSN, MPH, or MHA) preferred. 

  • Minimum 5 years of clinical nursing experience, with at least 2 years in quality assurance, clinical auditing, case management, or a comparable oversight role. 

  • Experience with in-home care, mobile health, home health, or community-based clinical services strongly preferred. 

  • Working knowledge of laboratory specimen collection, point-of-care testing, and common in-home diagnostic procedures. 

  • Familiarity with CLIA, OSHA, HIPAA, and applicable state and federal regulations governing clinical practice. 

Skills & Competencies 

  • Analytical mindset - comfortable working with audit data, performance metrics, and Excel or Tableau tools to identify patterns and prioritize action. 

  • Strong written and verbal communication skills, with the ability to deliver direct, constructive feedback to clinicians at all levels. 

  • Sound clinical judgment and meticulous attention to detail in reviewing documentation and observing procedures. 

  • Coaching and adult-learning skills; able to teach without alienating. 

  • Proficiency with electronic health records, quality management platforms, and Microsoft Office (Excel, Word, PowerPoint). 

  • Ability to work independently, manage a multi-state caseload, and prioritize across competing audits and projects. 

Working Conditions 

  • Hybrid role with a mix of remote chart review, virtual coaching, and field-based observation visits. 

  • Travel up to 50-60% (or as determined by the business) to member homes, partner sites, or other service locations for ride-alongs and audits. 

  • Occasional evening or weekend availability to observe practitioners working non-standard shifts. 

  • Must maintain a valid driver's license, reliable transportation, and current auto insurance. 

$80,000 - $85,000 a year
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
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