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Remote Utilization Review Rn Jobs in Prince Frederick, MD

Senior Network Security Engineer

Suitland, MD · Remote

$63 - $82.50/hr

... reviews, recertification, cleanup, and decommissioning. * Install, configure, maintain, patch ... remote users, certificates, authentication policies, availability, utilization, and user access ...

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Remote Utilization Review Rn information

See Prince Frederick, MD salary details

$22

$44

$72

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

As of Sep 8, 2026, the average hourly pay for remote utilization review rn in Prince Frederick, MD is $44.43, according to ZipRecruiter salary data. Most workers in this role earn between $35.10 and $51.01 per hour, depending on experience, location, and employer.

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 are the key skills and qualifications needed to thrive as a remote utilization review RN?

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 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 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 popular job titles related to Remote Utilization Review Rn jobs in Prince Frederick, MD?

For Remote Utilization Review Rn jobs in Prince Frederick, MD, the most frequently searched job titles are:

What cities near Prince Frederick, MD are hiring for Remote Utilization Review Rn jobs?

Cities near Prince Frederick, MD with the most Remote Utilization Review Rn job openings:

Infographic showing various Remote Utilization Review Rn job openings in Prince Frederick, MD as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 15% Part Time, 4% Contract, and 1% Nights. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $92,405 per year, or $44.4 per hour.

Senior Manager, Clinical Product Quality - Medical Device/Complaint Handling & Cardiovascular RN

Edwards Lifesciences Corporation

California, MD • On-site, Remote

Full-time

Posted 5 days ago


Edwards Lifesciences rating

8.2

Company rating: 8.2 out of 10

Based on 31 frontline employees who took The Breakroom Quiz

88th of 547 rated manufacturers


Job description

This position offers the flexibility of being fully remote, but the selected candidate must be currently residing within the United States.

Many structural heart patients suffer from heart failure with limited options. Our Implantable Heart Failure Management (IHFM) team is at the forefront of addressing these unmet patient needs through pioneering technology that enables early, targeted therapeutic intervention. Our innovative solutions are not just transforming patient care but also creating a unique and exciting environment for our team members. It's our driving force to help patients live longer and healthier lives. Join us and be part of our inspiring journey.

As a Senior Manager, Clinical Product Quality, you will be a member of Complaint Handling and Post Market Surveillance/Risk Management team to provide clinical guidance/clinical expert knowledge to Quality, Engineering and other cross functional teams to understand the nature of complaints and possible health risks. In this role you will ensure appropriate investigation of product complaints and adverse events, in order to escalate potential manufacturing, design, labeling and training issues. You will also follow standard practices and procedures in analyzing data, interpreting and drawing conclusions, with the objective of gathering key information and communicating to cross-functional teams who will utilize the information for improvement of product and procedural outcomes.

How you will make an impact:

  • Provides medical/clinical guidance to complaint investigators and engineers related to event interpretation, event investigation, proper coding, required regulatory reporting (Medical Device Reports, Medical Device Vigilance, etc.), and complaint closure. Author and/or review complaint conclusions/closure statements and customer letters. May assist with and help manage Imaging Reviews
  • Educates complaint investigators to understand nature of events and possible health risks
  • Interprets complaint data for complaint investigators, engineers, and other Quality department personnel
  • Authors clinically based product specific scripts to guide complaint investigators in appropriate investigational paths
  • Obtain and evaluate information from clinical specialists, sales staff, physicians, nurses and other hospital staff/customers, as needed to support complaint investigation and drive towards resolution
  • Provides training to complaint investigators on patient anatomy and medical conditions, and IHFM (Implantable Heart Failure Management) products and procedure
  • Provides complaint training to Sales, Marketing and other customer facing roles
  • Works with VP Product Safety and/or Director of Quality to maintain Decision Rationale Matrix to guide complaint investigators with reporting decisions.
  • Reviews complaint codes and FDA Medical Device Reports, reviews and assists with reporting decisions
  • Authors and/or reviews complaint conclusions/closure statements and customer letters
  • Analyzes and interprets complaint data for a specific product line, business unit, regulatory submissions, regulatory agency requests, and/or management report
  • Performs Complaint Trending Analyses and participates in Quality Metrics Reviewand Quality Data Review meetings where complaints are discussed
  • Communicates complaint data and relevant clinical information to internal customers in quality, manufacturing and new product development in support of complaint investigations
  • Participates in review of/provides clinical guidance for FMEAs (Failure Mode & Effects Analysis) and Risk Management Worksheets
  • Provides clinical input to Product Risk Assessments, and participate in Risk Management Councils and Quality Boards
  • Aid in response to Regulatory Agencies who inquire about complaint /Risk Management related issues

What you'll need (Required):

  • Bachelor's degree plus 10 years of relevant experience or equivalent work experience based on Edwards' criteria
  • Registered Nurse (RN) - current state license active or expired
  • Cardiac patient care experience (e.g. cardiac care, ICU, OR, or cardiovascular interventions)
  • Medical device industry experience in Quality/Compliance, with a strong preference for complaint handling, complaint investigation, and/or post-market surveillance

What else we look for (Preferred):

  • RN with Cath Lab, CVOR, or CVICU nursing experience
  • Expert knowledge of the FDA's Quality System Regulations; experience working within a Quality Management System. Strong working knowledge of Medical Device regulations, such as FDA 21 CFR 820, ISO 13485, ISO 14971, EU MDR, CMDR, MDD 93/42/EEC, and other applicable regulatory requirements.
  • Demonstrated subject matter expertise in clinical product quality, complaint handling, post-market surveillance, risk management, escalation, field action or related quality processes.
  • Proven successful project management and cross-functional leadership skills.
  • Ability to read and interpret documents such as Product Instructions for Use, Training and Procedure Manuals
  • Ability to write routine MDR (Medical Device Reports)/MIR (Manufacturer Incident Report) and routine correspondence
  • Ability to interpret patient medical records and clinical data to assess adverse events and potential device-related risks
  • Ability to speak effectively before groups of employees of organization
  • Ability to provide technical guidance, coaching, and feedback to peers and cross-functional partners without direct people-management responsibility.
  • Experience in developing or delivering training programs
  • Knowledge of computer application programs including Excel, PowerPoint and Word
  • Excellent written and oral English communication skills

Aligning our overall business objectives with performance, we offer competitive salaries, performance-based incentives, and a wide variety of benefits programs to address the diverse individual needs of our employees and their families.
The base pay range for this position is $145,000 to $205,000(highly experienced).
The pay for the successful candidate will depend on various factors (e.g., geographic location, qualifications, education, prior experience). Applications will be accepted while this position is posted on our Careers website.


Edwards is an Equal Opportunity/Affirmative Action employer including protected Veterans and individuals with disabilities.


What Edwards Lifesciences employees say

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About Edwards Lifesciences

Sourced by ZipRecruiter

Edwards Lifesciences is the global leader in patient-focused medical innovations for structural heart disease, as well as critical care and surgical monitoring. Driven by a passion to help patients, the company collaborates with the world's leading clinicians and researchers to address unmet healthcare needs, working to improve patient outcomes and enhance lives. Headquartered in Irvine, California, Edwards Lifesciences has extensive operations in North America, Europe, Japan, Latin America and Asia and currently employs over 15,000 individuals worldwide. For us, helping patients is not a slogan - it's our life's work. From developing devices that replace or repair a diseased heart valve to creating new technologies that monitor vital signs in the critical care setting, we focus on helping patients regain and improve the quality of their life.

Industry

Medical equipment and supplies manufacturing

Company size

10,000+ Employees

Headquarters location

Irvine, CA, US

Year founded

1958