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Assistant Remote Occupational Therapy Utilization Review Jobs in Virginia

Sentara Healthcare

UTILIZATION REVIEW NURSE

Norfolk, VA · On-site +1

The Utilization Review Nurse is responsible for utilization management services within the scope of ... For positions that are available as remote work, Sentara Health employs associates in the following ...

Prestige

LPN Case Manager

Richmond, VA · Remote

$75K/yr

... therapy, social services, dietary) * Coordinate and communicate with insurance companies and ... utilization review * Facilitate timely and safe discharge planning * Serve as primary point of ...

Cushman & Wakefield

Occupancy Planner

Arlington, VA · On-site +1

... utilization data, presenting recommendations to clients, and serving as the primary occupancy planning partner for stakeholders within their assigned region. *East Coast remote eligible for the right ...

Cushman & Wakefield

Occupancy Planner

Arlington, VA · On-site +1

... utilization data, presenting recommendations to clients, and serving as the primary occupancy planning partner for stakeholders within their assigned region. *East Coast remote eligible for the right ...

Cushman & Wakefield

Occupancy Planner

Arlington, VA · On-site +1

... utilization data, presenting recommendations to clients, and serving as the primary occupancy planning partner for stakeholders within their assigned region. *East Coast remote eligible for the right ...

Cushman & Wakefield

Occupancy Planner

Arlington, VA · On-site +1

... utilization data, presenting recommendations to clients, and serving as the primary occupancy planning partner for stakeholders within their assigned region. *East Coast remote eligible for the right ...

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All JobsOccupational Therapy Utilization Review JobsAssistant Remote Occupational Therapy Utilization Review JobsAssistant Remote Occupational Therapy Utilization Review Jobs in Virginia

Assistant Remote Occupational Therapy Utilization Review information

What is the difference between Assistant Remote Occupational Therapy Utilization Review vs Assistant Remote Physical Therapy Utilization Review?

AspectAssistant Remote Occupational Therapy Utilization ReviewAssistant Remote Physical Therapy Utilization Review
CertificationsOccupational Therapy Assistant (OTA) certificationPhysical Therapy Assistant (PTA) certification
Work EnvironmentRemote review of occupational therapy cases, healthcare settingsRemote review of physical therapy cases, healthcare settings
Employer & Industry UsageHospitals, clinics, insurance companiesHospitals, clinics, insurance companies
Common Search & ComparisonOften compared for similar roles in therapy utilization reviewRelated but focused on physical therapy cases

Both roles involve remote review of therapy cases, requiring relevant certifications and healthcare industry experience. The main difference lies in the therapy type—occupational versus physical therapy—each with specific certifications and case types. Understanding these distinctions helps job seekers identify the right role based on their credentials and interests.

What are the most commonly searched types of Remote Occupational Therapy Utilization Review jobs in Virginia?

The most popular types of Remote Occupational Therapy Utilization Review jobs in Virginia are:

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For Assistant Remote Occupational Therapy Utilization Review jobs in Virginia, the most frequently searched job titles are:

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Cities in Virginia with the most Assistant Remote Occupational Therapy Utilization Review job openings:

Assistant Remote Occupational Therapy Utilization Review jobs near you

UTILIZATION REVIEW NURSE

Norfolk, VA • On-site, Remote

Sentara Healthcare
Hospitals • 10K+ employees
Learn more about Sentara Healthcareexternal

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 15 days ago

Sentara Health rating

6.8

Company rating: 6.8 out of 10

Based on 417 frontline employees who took The Breakroom Quiz

496th of 898 rated healthcare providers

Job description

City/State
Norfolk, VA
Work Shift
First (Days)
Overview:
Sentara Health Plans Community Care is looking to hire a Utilization Review Nurse.
The Utilization Review Nurse is responsible for utilization management services within the scope of licensure. Conducts primary functions of prior authorization, retrospective review, medical director referrals and execution of member/provider approval and/or denial letter. Reviews provider requests for services requiring authorization. Conducts pre-certification, care coordination for appropriateness of treatment, set reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
Responsible for written and/or verbal notification to members and providers. Ensures medical director written decision is consistent with criteria (CMS, state, medical policy, clinical criteria). Facilitates accreditation by knowing, understanding, correctly interpreting, and accurately applying accrediting and regulatory requirements and standards.
Education:
• BSN (preferred)
Certification:
• Registered Nurse (required)
Experience:
• 3 years of acute care clinical experience (required)
• Previous Utilization Review experience (preferred)
• Milliman experience (preferred)
• Knowledge of NCQA (preferred)
• Microsoft suite (Word, Excel, Outlook) (preferred)
• Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills
Keywords: Talroo- Health, Utilization Review Nurse, RN, Care Coordination, or Discharge Planning, Case Management, Milliman, NCQA
Benefits: Caring For Your Family and Your Career
• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to 10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance - 5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down - 10,000
• Pet Insurance
• Legal Resources Plan
• Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission "to improve health every day," this is a tobacco-free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

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