Weekend only position. * 4 - eight hour weekend shifts a month required. * At least 1 major holiday ... Most of the training will be remote however you will be required to start onsite A Utilization ...
Weekend only position. * 4 - eight hour weekend shifts a month required. * At least 1 major holiday ... Most of the training will be remote however you will be required to start onsite A Utilization ...
Utilization Management Coordinator
Nottingham, MD · On-site +1
$21.70 - $27/hr
This is a full-time, remote position working five 8-hour days per week. Shifts are scheduled ... Review member inpatient status and clinical documentation to support episode updates * Ensure ...
Utilization Management Coordinator
Nottingham, MD · On-site +1
$21.70 - $27/hr
This is a full-time, remote position working five 8-hour days per week. Shifts are scheduled ... Review member inpatient status and clinical documentation to support episode updates * Ensure ...
Clinical Guide Part A: (UM) Utilization Management Nurse
Nottingham, MD · On-site +1
$82K - $96K/yr
This is a full-time, remote position working five 8-hour days. We are hiring for several schedules ... review * Ability to work one of the posted schedules, including a weekend day for most schedules ...
Clinical Guide Part A: (UM) Utilization Management Nurse
Nottingham, MD · On-site +1
$82K - $96K/yr
This is a full-time, remote position working five 8-hour days. We are hiring for several schedules ... review * Ability to work one of the posted schedules, including a weekend day for most schedules ...
Clinical Guide: (UM) Utilization Management Nurse (Outpatient Prior Authorization)
Nottingham, MD · On-site +1
$82K - $96K/yr
You'll be responsible for clinical review of outpatient authorization requests - applying evidence ... This is a full-time, remote position working five 8-hour days, 40 hours per week. We are hiring for ...
Clinical Guide: (UM) Utilization Management Nurse (Outpatient Prior Authorization)
Nottingham, MD · On-site +1
$82K - $96K/yr
You'll be responsible for clinical review of outpatient authorization requests - applying evidence ... This is a full-time, remote position working five 8-hour days, 40 hours per week. We are hiring for ...
Senior Director, Complex Care Management and Utilization Management - 2947
Baltimore, MD · On-site +1
Certification in Case Management (CCM), Utilization Review Accreditation Commission (URAC), or related credentials is a plus. Working conditions This job operates in a remote location from your home ...
Senior Director, Complex Care Management and Utilization Management - 2947
Baltimore, MD · On-site +1
Certification in Case Management (CCM), Utilization Review Accreditation Commission (URAC), or related credentials is a plus. Working conditions This job operates in a remote location from your home ...
Clinical Analyst
Baltimore, MD · Remote
Remote JobDuration: Contract / FTE Client: Federal Criteria-Need US citizenshipbecause of federal ... Utilization Management / Utilization Review / Prior Authorization * Clinical or healthcare ...
Clinical Analyst
Baltimore, MD · Remote
Remote JobDuration: Contract / FTE Client: Federal Criteria-Need US citizenshipbecause of federal ... Utilization Management / Utilization Review / Prior Authorization * Clinical or healthcare ...
The ideal candidate will have previous experience performing utilization review within a healthcare payor organization. ESSENTIAL FUNCTIONS: * Utilize clinical expertise and critical thinking skills ...
The ideal candidate will have previous experience performing utilization review within a healthcare payor organization. ESSENTIAL FUNCTIONS: * Utilize clinical expertise and critical thinking skills ...
Experience: 3 years acute clinical experience, previous case management, discharge planning or utilization review experience. Preferred Qualifications: * Bachelor's degree in Nursing. Knowledge ...
Experience: 3 years acute clinical experience, previous case management, discharge planning or utilization review experience. Preferred Qualifications: * Bachelor's degree in Nursing. 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
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 ...
Care Manager (Remote)
Baltimore, MD · Remote
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 ...
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 ...
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 ...
Medical Review Nurse III
Baltimore, MD · 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 ...
Medical Review Nurse III
Baltimore, MD · 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 ...
... Utilization Review. Preferred Qualifications: * Knowledge and experience with MCG * Experience working with Commercial and Federal Employee Program employee group member and Medicare/Medicaid ...
... Utilization Review. Preferred Qualifications: * Knowledge and experience with MCG * Experience working with Commercial and Federal Employee Program employee group member and Medicare/Medicaid ...
Remote Compensation Analyst
Silver Spring, MD · On-site +1
$101K - $135K/yr
Collaborate with HR and business leaders in drafting, reviewing, and updating s. * Provide ... Proficiency in compensation survey data utilization, with Radford & Mercer industry surveys ...
Remote Compensation Analyst
Silver Spring, MD · On-site +1
$101K - $135K/yr
Collaborate with HR and business leaders in drafting, reviewing, and updating s. * Provide ... Proficiency in compensation survey data utilization, with Radford & Mercer industry surveys ...
Telephonic Case Manager I - California RN License Required
Nottingham, MD · Remote
$63K - $95K/yr
Strong cost containment background, such as utilization review or managed care helpful ... Remote
Telephonic Case Manager I - California RN License Required
Nottingham, MD · Remote
$63K - $95K/yr
Strong cost containment background, such as utilization review or managed care helpful ... Remote
Telephonic Case Manager I
Nottingham, MD · Remote
$63K - $95K/yr
Strong cost containment background, such as utilization review or managed care helpful ... Remote
Telephonic Case Manager I
Nottingham, MD · Remote
$63K - $95K/yr
Strong cost containment background, such as utilization review or managed care helpful ... Remote
Telephonic Case Manager I
Nottingham, MD · Remote
$63K - $95K/yr
Strong cost containment background, such as utilization review or managed care helpful ... Remote
Quick apply
Telephonic Case Manager I
Nottingham, MD · Remote
$63K - $95K/yr
Strong cost containment background, such as utilization review or managed care helpful ... Remote
Telephonic Case Manager I - California RN License Required
Nottingham, MD · Remote
$63K - $95K/yr
Strong cost containment background, such as utilization review or managed care helpful ... Remote
Quick apply
Telephonic Case Manager I - California RN License Required
Nottingham, MD · Remote
$63K - $95K/yr
Strong cost containment background, such as utilization review or managed care helpful ... Remote
Remote Psychiatrist
Leonardtown, MD · Remote
$150 - $200/hr
Document within our behavioral health EMR to the standard required for payer review * Escalate ... Flexible scheduling, including evening and weekend availability * Malpractice coverage provided
Quick apply
Remote Psychiatrist
Leonardtown, MD · Remote
$150 - $200/hr
Document within our behavioral health EMR to the standard required for payer review * Escalate ... Flexible scheduling, including evening and weekend availability * Malpractice coverage provided
Remote Weekend Utilization Review information
What is the difference between Remote Weekend Utilization Review vs Remote Weekday Utilization Review?
| Aspect | Remote Weekend Utilization Review | Remote Weekday Utilization Review |
|---|---|---|
| Credentials | Typically requires a healthcare professional license and utilization review certification | Same as weekend role, healthcare license and utilization review certification |
| Work Environment | Remote, weekend hours, often part-time or flexible | Remote, weekday hours, standard business hours |
| Employer & Industry | Health insurance companies, third-party administrators | Same as weekend role, health insurance industry |
| Work Schedule | Primarily weekends, possibly evenings | Weekdays, regular business hours |
Remote Weekend Utilization Review and Remote Weekday Utilization Review roles are similar in credentials and industry but differ mainly in work schedule. Weekend roles focus on reviewing cases during weekends, offering flexibility, while weekday roles follow standard business hours. Both positions require healthcare licensing and utilization review certification, serving health insurance companies and third-party administrators.
What are the most commonly searched types of Weekend Utilization Review jobs in Maryland?
The most popular types of Weekend Utilization Review jobs in Maryland are:
What are popular job titles related to Remote Weekend Utilization Review jobs in Maryland?
For Remote Weekend Utilization Review jobs in Maryland, the most frequently searched job titles are:
- Contract Utilization Review Nurse
- Medical Claim Review Nurse
- Remote Medical Review Nurse
- Remote Utilization Review Rn
- Freelance Utilization Review Nurse
- Utilization Management Coordinator
- Non Exempt No Experience Utilization Management Nurse
- Evening Utilization Review Nurse
- Home Based Utilization Review Nurse
- Remote Utilization Review Social Worker
What job categories do people searching Remote Weekend Utilization Review jobs in Maryland look for?
The top searched job categories for Remote Weekend Utilization Review jobs in Maryland are:
- Authorization Utilization Review Bcba
- Insurance Utilization Review
- Lpn Utilization Review Work From Home
- Remote Dental Utilization Review
- Clinical Review Coordinator
- Cigna Utilization Review Nurse
- Director Of Utilization Review
- Weekend Utilization Review
- Utilization Review Coordinator
- Seasonal Remote Utilization Review
What cities in Maryland are hiring for Remote Weekend Utilization Review jobs?
Cities in Maryland with the most Remote Weekend Utilization Review job openings:
Full-time
Posted 11 days ago
Job description
Job Requirements
Work Experience
Employment Type: OTHER
- Weekend only position.
- 4 - eight hour weekend shifts a month required.
- At least 1 major holiday required.
- Only serious applicants should apply.
- Recent UR / MCG experience.
- Most of the training will be remote however you will be required to start onsite
A Utilization Review (UR) Nurse is a registered nurse who bridges the gap between healthcare providers and insurance companies. They evaluate patient medical records to ensure treatments, procedures, and hospital stays are clinically necessary, cost-effective, and meet established insurance guidelines.
- Medical Necessity Reviews: They verify that admissions, surgeries, and treatments are medically necessary by comparing patient charts to standardized, evidence-based guidelines like Milliman Care Guidelines (MCG) or InterQual.
- Concurrent & Retrospective Reviews: They review ongoing hospital stays (concurrent) to authorize continuing care, and review charts after discharge (retrospective) to prevent claim denials and ensure accurate billing.
- Insurance Liaison: They act as a go-between, submitting clinical data to insurance companies to secure prior authorizations and ongoing approvals so the hospital gets properly reimbursed.
- Resource Optimization: They monitor the patient's progress to ensure they are in the appropriate level of care (e.g., observation vs. inpatient) and help coordinate discharges to lower levels of care.
Work Experience
Education
* 4 year/ Bachelor's degree in Nursing (Required)
Master's Degree in Nursing (Preferred)
Experience and Skills
Recent UR / MCG experience.
Required Skills: Strong Verbal Communications Skills, Strong Written Communications Skills, Excel Intermediate Level, PowerPoint - Intermediate Level, MS Word - Intermediate Level, Excellent Organizational Skills
Employment Type: OTHER