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Remote Utilization Review Jobs in Rosedale, MD (NOW HIRING)

Medical Review Nurse III

Baltimore, MD ยท On-site +1

$80K - $95K/yr

A minimum of three (3) or more years' experience in medical/utilization medical record review ... Ability to work well in a remote team environment, to collaborate with others, and interface with ...

A minimum of three (3) or more years' experience in medical/utilization medical record review ... Ability to work well in a remote team environment, to collaborate with others, and interface with ...

While this position is remote, the incumbent will be expected to come into a CareFirst location ... Utilization Review, Disease Management or other direct patient care experience. Preferred ...

... Utilization Review. Preferred Qualifications: * Knowledge and experience with MCG * Experience working with Commercial and Federal Employee Program employee group member and Medicare/Medicaid ...

Remote About J29 J29 is an employee centered healthcare management consulting company that ... Requires 5-7 years work experience (this could be a combination of clinical and utilization review ...

New

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Remote Utilization Review information

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$66

How much do remote utilization review jobs pay per hour?

As of Sep 5, 2026, the average hourly pay for remote utilization review 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?

A Remote Utilization Review job involves assessing medical records and treatment plans to ensure they meet insurance guidelines and medical necessity criteria. Professionals in this role, often nurses or healthcare specialists, work remotely to review patient care for cost-effectiveness and compliance with policies. They collaborate with healthcare providers, insurance companies, and case managers to approve or deny services based on established guidelines. This position requires strong analytical skills, knowledge of medical policies, and attention to detail.

What does a remote utilization review do?

A typical day for a Remote Utilization Review professional involves reviewing patient medical records, evaluating the necessity of proposed treatments against established guidelines, and collaborating with healthcare providers to gather additional information when needed. You will spend much of your time analyzing documentation, submitting recommendations, and ensuring that care authorization decisions align with payer policies and clinical best practices. Communication with case managers, physicians, and insurance representatives is frequent and essential. The work is generally independent and deadline-driven but requires strong teamwork and responsiveness through virtual meetings, emails, and calls.

What are the key skills and qualifications needed to thrive in remote utilization review?

To thrive as a Remote Utilization Review professional, you need a solid foundation in clinical knowledge, critical thinking, and an active RN or LPN license, often supported by experience in case management or prior authorization. Familiarity with medical coding (ICD-10, CPT), electronic health records (EHRs), and utilization management software is typically required, along with URAC or related certifications. Excellent communication, attention to detail, and strong organizational skills help you efficiently manage cases and coordinate with providers and payers. These skills ensure accurate assessments of medical necessity, compliance with regulations, and effective remote collaboration with healthcare teams.

What are popular job titles related to Remote Utilization Review jobs in Rosedale, MD?

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

What cities near Rosedale, MD are hiring for Remote Utilization Review jobs?

Cities near Rosedale, MD with the most Remote Utilization Review job openings:

Infographic showing various Remote Utilization Review job openings in Rosedale, MD as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 13% Part Time, 4% Contract, and 1% Nights. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution, with an average salary of $84,352 per year, or $40.6 per hour.

Licensed Clinical Social Worker (LCSW) - Remote Full-Time Position at Desta Care Therapeutic

Desta Care Therapeutic

Baltimore, MD โ€ข Remote

$90K - $105K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 2 days ago

New


Key responsibilities

  • Act as a liaison between clients, families, and healthcare providers to ensure comprehensive support.

  • Interact with insurance companies to manage pre-certifications and utilization processes.

  • Contribute to discharge planning and aftercare strategies to facilitate client transitions.


Job description

Position Overview

Desta Care Therapeutic is seeking a dedicated and compassionate Licensed Clinical Social Worker (LCSW) to join our multidisciplinary team. In this full-time remote role, you will utilize your expertise in mental health to support individuals navigating complex emotional and psychological challenges. Your focus will be on delivering personalized care and making a meaningful impact in the lives of our clients, particularly within the hospice care setting.

About the Organization

Desta Care Therapeutic specializes in providing high-quality mental health services designed for a diverse population that includes individuals from various backgrounds and life experiences. We pride ourselves on creating a supportive and inclusive environment that prioritizes the well-being and personal growth of both our clients and staff. Our team comprises experienced professionals committed to promoting healing, empowerment, and resilience in our clients.

Work Environment

This remote position allows flexibility while working in a collaborative environment. You will engage with your peers either virtually or via telehealth platform, ensuring that communication remains seamless and effective. Though location-independent, our organization maintains a strong sense of community and teamwork, with regular check-ins and virtual meetings to foster collaboration and shared professional development.

Key Responsibilities
  • Act as a critical liaison between clients, families, and outpatient healthcare providers, ensuring comprehensive support for each individualโ€™s needs.
  • Interact with insurance companies to manage pre-certifications and utilization processes necessary for effective care continuity.
  • Contribute to discharge planning and aftercare strategies that facilitate a smooth transition for clients post-treatment.
  • Provide therapeutic meal support, empowering clients to establish a healthy relationship with food while demonstrating effective coping strategies.
  • Deliver empathetic, affirming, and tailored care to clients, considering their unique circumstances and intersectional identities.
  • Document and review client interactions and care plans in accordance with industry standards, ensuring compliance and promoting quality care delivery.
Patient Population / Client Focus

Your primary focus will be on older adults within a hospice care framework, addressing their complex emotional and psychological needs during a critical phase of life. Through careful assessment and individualized intervention, you will help clients navigate their feelings and experiences related to end-of-life issues, all within a safe and sensitive environment.

Qualifications
  • Master's degree in Social Work from an accredited institution is required.
  • A valid LCSW license in the state of Maryland is mandatory.
  • Demonstrable experience working with older adult populations, particularly in complex care settings.
  • Strong clinical and diagnostic skills, with a solid understanding of mental health principles.
  • Excellent communication and interpersonal skills to build rapport with clients and collaborate with team members.
  • A self-starter mentality, able to work independently while also being a constructive team player.
Preferred Experience
  • Experience with hospice or palliative care environments is highly desirable.
  • Familiarity with mental health regulations, documentation protocols, and utilization review processes.
  • Proficiency in using electronic health record (EHR) systems and telehealth platforms.
Compensation and Benefits

The compensation for this role ranges from $90,000 to $105,000 per year, commensurate with experience and qualifications. We offer a comprehensive benefits package that includes:

  • Competitive salary with periodic reviews.
  • Comprehensive health plans including Medical, Dental, and Vision coverage.
  • A 401(k) plan with employer matching and Flex Spending options.
  • Life insurance and coverage for short-term disability.
  • Generous paid time off and continuous professional development opportunities.
Career Growth Opportunities

At Desta Care Therapeutic, we prioritize the professional growth of our team members. You will have access to ongoing training, mentorship programs, and the chance to engage in leadership roles as you continue to develop your career in social work. We believe in fostering talent from within and encourage all employees to pursue their interests in specialized fields of practice.

Why Join Our Team

If you're seeking a fulfilling role that blends clinical expertise with compassionate care, Desta Care Therapeutic is the right place for you. By joining our team, you will be part of an organization that values your insights and fosters a culture of teamwork, respect, and appreciation. Together, we can make a significant impact on the lives of our clients and contribute to the advancement of mental health care.

Application Information

If you are passionate about social work and dedicated to enhancing the lives of those in hospice care, we invite you to apply today. Please submit your resume and a cover letter detailing your relevant experience and motivation for applying to this position. We look forward to connecting with candidates who share our commitment to exceptional client care.