Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Registered Nurse - AI Trainer
Baltimore, MD · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
Quick apply
Registered Nurse - AI Trainer
Baltimore, MD · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
Registered Nurse - AI Trainer
Alexandria, VA · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
Quick apply
Registered Nurse - AI Trainer
Alexandria, VA · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Quick apply
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Quick apply
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Registered Nurse - AI Trainer
Washington, DC · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
Quick apply
Registered Nurse - AI Trainer
Washington, DC · Remote
$50 - $60/hr
Contribute to developing cutting-edge AI systems, while enjoying the flexibility of remote work and ... MDs, PAs, and Nurses. Advantages of contracting with us: * You'll be able to choose which projects ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Quick apply
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Utilization Management Specialist (UM / Utilization Review Nurse) -- Remote Location: 100% Remote ... Active RN or LPN license (RN preferred) -- Maryland compact/eligibility required * 5+ years ...
Psychiatric Nurse Practitioner (PMHNP) - Telehealth
Washington, DC · Remote
$84 - $115/hr
Flexible & Remote Telemedicine: Evidence-based approach to psychiatric care via telemedicine ... Active and clear APRN license * Licensed Nurse Practitioner - Certified in Psychiatric & Mental ...
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Psychiatric Nurse Practitioner (PMHNP) - Telehealth
Washington, DC · Remote
$84 - $115/hr
Flexible & Remote Telemedicine: Evidence-based approach to psychiatric care via telemedicine ... Active and clear APRN license * Licensed Nurse Practitioner - Certified in Psychiatric & Mental ...
Psychiatric Nurse Practitioner (PMHNP) - Telehealth
Millersville, MD · Remote
$84 - $115/hr
Flexible & Remote Telemedicine: Evidence-based approach to psychiatric care via telemedicine ... Active and clear APRN license * Licensed Nurse Practitioner - Certified in Psychiatric & Mental ...
Quick apply
Psychiatric Nurse Practitioner (PMHNP) - Telehealth
Millersville, MD · Remote
$84 - $115/hr
Flexible & Remote Telemedicine: Evidence-based approach to psychiatric care via telemedicine ... Active and clear APRN license * Licensed Nurse Practitioner - Certified in Psychiatric & Mental ...
The Clinical Navigator (RN) conducts concurrent review of inpatient level of care, managing the timely and smooth transition from inpatient care to home or other levels of care. Utilizing experience ...
The Clinical Navigator (RN) conducts concurrent review of inpatient level of care, managing the timely and smooth transition from inpatient care to home or other levels of care. Utilizing experience ...
Experience with telehealth platforms, remote patient monitoring, and EHR systems is essential. * Licensure/Certification: Current active licensure as a Registered Nurse (RN), Licensed Clinical Social ...
Experience with telehealth platforms, remote patient monitoring, and EHR systems is essential. * Licensure/Certification: Current active licensure as a Registered Nurse (RN), Licensed Clinical Social ...
Work from the comfort of home (fully remote) * Flexible schedule - you set your own hours. * Free ... Also, we are unable to accept substance abuse counselors, school counselors, registered nurses ...
Quick apply
Work from the comfort of home (fully remote) * Flexible schedule - you set your own hours. * Free ... Also, we are unable to accept substance abuse counselors, school counselors, registered nurses ...
Licensed Psychologist - Remote
Baltimore, MD · Remote
$55 - $70/hr
Work from the comfort of home (fully remote) * Flexible schedule - you set your own hours. * Free ... Also, we are unable to accept substance abuse counselors, school counselors, registered nurses ...
Quick apply
Licensed Psychologist - Remote
Baltimore, MD · Remote
$55 - $70/hr
Work from the comfort of home (fully remote) * Flexible schedule - you set your own hours. * Free ... Also, we are unable to accept substance abuse counselors, school counselors, registered nurses ...
CCT, CRAT, FMG, RN, LPN, EMT-I or Paramedic (Preferred) * CCT CRAT RN or Paramedic (Preferred) Compensation: This is an hourly role starting at $22 per hour and up, DOE. We pay hourly shift ...
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CCT, CRAT, FMG, RN, LPN, EMT-I or Paramedic (Preferred) * CCT CRAT RN or Paramedic (Preferred) Compensation: This is an hourly role starting at $22 per hour and up, DOE. We pay hourly shift ...
Holter/Cardiac Technologist
Rockville, MD · On-site +1
$22/hr
... RN and LPNs with experience in ECG assessment, evaluation of arrhythmia and a thorough respect for accurate data processing and comprehensive reporting. * A minimum of 1+ years working in a remote ...
Holter/Cardiac Technologist
Rockville, MD · On-site +1
$22/hr
... RN and LPNs with experience in ECG assessment, evaluation of arrhythmia and a thorough respect for accurate data processing and comprehensive reporting. * A minimum of 1+ years working in a remote ...
Holter/Cardiac Technologist
Rockville, MD · Remote
$22/hr
... RN and LPNs with experience in ECG assessment, evaluation of arrhythmia and a thorough respect for accurate data processing and comprehensive reporting. * A minimum of 1+ years working in a remote ...
Holter/Cardiac Technologist
Rockville, MD · Remote
$22/hr
... RN and LPNs with experience in ECG assessment, evaluation of arrhythmia and a thorough respect for accurate data processing and comprehensive reporting. * A minimum of 1+ years working in a remote ...
Temporary Remote Rn information
How to make 2000 a week working from home?
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What is the best remote job for a nurse?
What are the key skills and qualifications needed to thrive as a Temporary Remote RN, and why are they important?
What are Temporary Remote RNs?
How to make an extra 2000 a month as a nurse?
What are some common challenges faced by Temporary Remote RNs, and how can they be managed?
What is the difference between Temporary Remote Rn vs Permanent Remote Rn?
| Aspect | Temporary Remote Rn | Permanent Remote Rn |
|---|---|---|
| Duration of employment | Short-term, project-based or seasonal | Long-term, ongoing employment |
| Work arrangement | Remote with potential for on-site shifts | Fully remote, consistent schedule |
| Credentials required | Registered Nurse license, possibly additional certifications | Registered Nurse license, similar certifications |
| Employer type | Hospitals, clinics, staffing agencies | Hospitals, healthcare organizations, telehealth companies |
Temporary Remote Rn roles are short-term positions often filled through staffing agencies, ideal for project-based work. Permanent Remote Rn roles offer ongoing employment with consistent remote work, suitable for nurses seeking stability. Both roles require RN licensure and similar certifications, but differ mainly in duration and employment structure.
Contractor
Medical, Dental, Vision, Life, Retirement
Posted 21 days ago
Job description
Utilization Management Specialist (UM / Utilization Review Nurse) — Remote
Location: 100% Remote (U.S.) — Maryland compact/eligibility required Type: Contract (approx. 3 months; potential extension) Schedule: Mon–Fri, 8:00am–5:00pm ET (1-hour lunch) - Flex after ramp-up start time between 7:00am–9:00am ET Pay (W2): USD 51.00/H
Job overview
In this role, you’ll use your clinical background and utilization management experience to review requests for care and determine medical necessity, appropriateness, and benefit coverage. You’ll work fully remote and leverage MCG, medical policy, and regulatory guidelines while collaborating with Medical Directors and internal teams to support timely, accurate authorization decisions.
What you’ll do
- Perform prospective, concurrent, and retrospective utilization reviews (medical + behavioral health).
- Make medical necessity / appropriateness determinations and support prior authorizations.
- Use clinical criteria and policy resources daily (including MCG / Milliman Care Guidelines).
- Review clinical documentation, benefits, and mandates to ensure services align with coverage and guidelines.
- Research diagnoses/treatments and high-cost services; summarize findings and escalate complex cases to Medical Directors as needed.
- Collaborate with internal partners and providers to support benefit application and appropriate levels/settings of care.
- Maintain accurate documentation and protect PHI while managing a busy caseload.
Required qualifications
- Active RN or LPN license (RN preferred) — Maryland compact/eligibility required
- 5+ years clinical nursing experience
- 2+ years care management / utilization management experience
- MCG experience (required)
- Experience supporting Commercial/FEP/Medicare lines of business and applying medical policy/regulatory standards
- Strong critical thinking, written communication, and ability to work independently in a remote setting
- Comfortable with web-based tools + Microsoft Office (Word/Excel/PowerPoint)
- Guiding Care and FACETS (required)
Nice to have
- Critical Care or ER clinical background
- Experience with LCD/NCD, Medicare guidelines, ASAM, or other authorization criteria sets
System One, and its subsidiaries including Joulé and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.
System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.
#M-1 #LI-AJ1 Ref: #851-Rockville-S1