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Weekend Utilization Review Jobs in Baltimore, MD

Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource utilization; enters clinical review in EPIC; maintains close communication with ...

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Weekend Utilization Review information

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$21

$42

$68

How much do weekend utilization review jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for weekend utilization review in Baltimore, MD is $42.01, according to ZipRecruiter salary data. Most workers in this role earn between $33.22 and $48.27 per hour, depending on experience, location, and employer.

What is a weekend utilization review?

A Weekend Utilization Review job involves assessing patient care and medical services during weekends to ensure they meet medical necessity and insurance guidelines. Professionals in this role review clinical documentation, coordinate with healthcare providers, and determine appropriate levels of care for patients. They typically work for hospitals, insurance companies, or other healthcare organizations. Strong analytical skills, medical knowledge, and familiarity with regulatory requirements are essential for success in this role.

What does a weekend utilization review professional do?

Weekend Utilization Review professionals typically work independently, reviewing patient cases for medical necessity, appropriateness of care, and compliance with payer guidelines during non-standard business hours. You will analyze patient charts, interact with clinical staff, and document findings, often collaborating remotely with other care coordinators or medical teams. While much of the role is desk-based, quick decision-making and effective communication are essential due to faster-paced weekend workflows. This schedule can offer greater autonomy and flexibility, but may also require prioritizing tasks and managing multiple cases efficiently to ensure continuous patient care.

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

Success as a Weekend Utilization Review professional requires a strong background in nursing or healthcare, critical thinking skills, and a thorough understanding of medical necessity criteria, such as InterQual or Milliman guidelines. Familiarity with electronic medical records (EMR) systems and utilization management software is highly beneficial, and RN or healthcare-related licensure is often required. Exceptional communication, attention to detail, and the ability to work independently on weekends are crucial soft skills. Mastering these areas allows efficient and accurate reviews of patient care, supporting optimal healthcare resource allocation outside of standard work hours.

What are the most commonly searched types of Utilization Review jobs in Baltimore, MD?

The most popular types of Utilization Review jobs in Baltimore, MD are:

What cities near Baltimore, MD are hiring for Weekend Utilization Review jobs?

Cities near Baltimore, MD with the most Weekend Utilization Review job openings:

Infographic showing various Weekend Utilization Review job openings in Baltimore, 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 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $87,387 per year, or $42 per hour.

Utilization Management Specialist

System One

Baltimore, MD โ€ข Remote

Contractor

Medical, Dental, Vision, Life, Retirement

Re-posted 9 hours 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


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About System One

Sourced by ZipRecruiter

System One helps employers get work done more efficiently and economically without compromising quality. Over our 35+ year history, we've helped connect thousands of talented people with innovative companies. The excitement of a perfect fit motivates us every single day.

Industry

Business consulting services and recruiting and staffing services

Company size

5,001 - 10,000 Employees

Headquarters location

Pittsburgh, PA, US