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Case Manager Utilization Review Nurse Jobs in Reston, VA

UHS

Utilization Review Coordinator

Washington, DC · On-site

$33.60 - $50.40/hr

Informs department director of changes in managed care companies. Maintains awareness of unique ... Six months psychiatric utilization review either for hospital or external review organization ...

UHS

Utilization Review Coordinator

Washington, DC · On-site

Informs department director of changes in managed care companies. Maintains awareness of unique ... Six months psychiatric utilization review either for hospital or external review organization ...

UHS

Utilization Review Coordinator

Washington, DC · On-site

Informs department director of changes in managed care companies. Maintains awareness of unique ... Six months psychiatric utilization review either for hospital or external review organization ...

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Case Manager Utilization Review Nurse information

See Reston, VA salary details

$20

$49

$83

How much do case manager utilization review nurse jobs pay per hour?

As of Sep 3, 2026, the average hourly pay for case manager utilization review nurse in Reston, VA is $49.45, according to ZipRecruiter salary data. Most workers in this role earn between $36.78 and $59.76 per hour, depending on experience, location, and employer.

What is a case manager utilization review nurse?

A Case Manager Utilization Review Nurse is a registered nurse who evaluates the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They review patient records, coordinate with healthcare providers, and ensure that treatments meet established guidelines and insurance requirements. Their goal is to optimize patient outcomes while controlling healthcare costs and ensuring compliance with regulations. These nurses also help facilitate communication between patients, providers, and payers to support effective care management.

How does a case manager utilization review nurse typically collaborate with physicians and other healthcare providers?

Case Manager Utilization Review Nurses regularly work with physicians, social workers, and other healthcare professionals to ensure patients receive appropriate care while managing resource utilization. They often participate in interdisciplinary team meetings to discuss care plans, review patient progress, and address any barriers to discharge. Building strong communication channels and maintaining up-to-date clinical knowledge are essential, as nurses must advocate for patients while also supporting evidence-based practices and regulatory compliance. This collaborative environment helps streamline patient care and optimize outcomes.

What are the key skills and qualifications needed to thrive as a case manager utilization review nurse, and why are they important?

To excel as a Case Manager Utilization Review Nurse, you need a solid background in nursing, strong clinical assessment skills, and a valid RN license, often with case management certification. Familiarity with utilization review software, electronic health record (EHR) systems, and knowledge of insurance and regulatory guidelines is essential. Exceptional communication, critical thinking, and negotiation abilities set top performers apart in this role. These qualifications ensure effective patient advocacy, cost-effective care, and compliance with healthcare standards.

What is the difference between Case Manager Utilization Review Nurse vs Case Manager?

AspectCase Manager Utilization Review NurseCase Manager
CredentialsRN license, certification in utilization review (e.g., URAC)RN license, case management certification (e.g., CCM)
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, community health, insurance providers
Primary FocusReviewing medical necessity and appropriateness of careCoordinating patient care and discharge planning

While both roles involve patient care coordination, the Case Manager Utilization Review Nurse primarily focuses on reviewing medical necessity and insurance approvals, whereas the Case Manager handles broader patient care coordination and discharge planning. Both roles require nursing credentials and are vital in healthcare settings, but their specific responsibilities differ.

What are popular job titles related to Case Manager Utilization Review Nurse jobs in Reston, VA?

For Case Manager Utilization Review Nurse jobs in Reston, VA, the most frequently searched job titles are:

What job categories do people searching Case Manager Utilization Review Nurse jobs in Reston, VA look for?

The top searched job categories for Case Manager Utilization Review Nurse jobs in Reston, VA are:

What cities near Reston, VA are hiring for Case Manager Utilization Review Nurse jobs?

Cities near Reston, VA with the most Case Manager Utilization Review Nurse job openings:

Case Manager Utilization Review Nurse jobs near you
Infographic showing various Case Manager Utilization Review Nurse job openings in Reston, VA as of August 2026, with employment types broken down into 74% Full Time, 16% Part Time, and 10% Contract. Highlights an 89% In-person, and 11% Remote job distribution, with an average salary of $102,859 per year, or $49.5 per hour.

Travel Nurse RN - Case Manager, Utilization Review - $2,150 per week

AMN Healthcare Revenue Cycle

Woodbridge, VA • On-site

$2.1K/wk

Other

Medical, Dental, Vision, Life, Retirement

This job post has expired 1 day ago. Applications are no longer accepted.

Job description

AMN Healthcare Revenue Cycle is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Woodbridge, Virginia.

Job Description & Requirements
  • Specialty: Utilization Review
  • Discipline: RN
  • Start Date: ASAP
  • Duration: 13 weeks
  • 36 hours per week
  • Shift: 12 hours
  • Employment Type: Travel

Job Description & Requirements
RN CM
StartDate: 8/24/2026 Pay Rate: $1800.00 - $2500.00
POSITION SUMMARY 2 RN CM
POSITION DUTIES DCP
MINIMUM REQUIRED QUALIFICATIONS MSW; 2+ years minimum of acute care hospital experience
PREFERRED QUALIFICATIONS Experienced traveler with lots of LOS expereince
LENGTH OF ASSIGNMENT 13 weeks
SHIFT / HOURS PER WEEK 8:30-5:00 Monday - Friday
SYSTEMS EPIC
START DATE ASAP
Job Benefits
Becoming an AMN Healthcare professional gives you the incredible opportunity to gain critical career experience, work with new people, and earn a highly competitive salary—but the perks don't stop there. There are many additional benefits to enjoy, including:

  • Medical, dental and vision benefits
  • Earned time off and paid holidays
  • Paid continuing education time
  • 401(K) retirement planning
  • Short-term disability, life insurance, paid jury duty
  • Access to the largest network of facilities and providers in the country
  • Industry experienced workforce management team
  • Licensure and certification reimbursement

About the Company
At AMN Healthcare, we strive to be recognized as the most trusted, innovative, and influential force in helping healthcare organizations provide quality patient care that continually evolves to make healthcare more human, more effective, and more achievable.

AMN Healthcare Revenue Cycle Job ID #3559616. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: RN CM

About AMN Healthcare Revenue Cycle

AMN Healthcare is a leading force in the healthcare industry, committed to being the most trusted, innovative, and influential partner for healthcare organizations. With a focus on providing quality patient care, AMN Healthcare offers holistic solutions that reduce costs, streamline processes, and improve efficiencies. The company boasts over 30 years of experience and takes pride in staffing leading healthcare facilities with the nation's best travelers. As an industry leader, AMN Healthcare offers a diverse team dedicated to supporting healthcare workers and facilities, ensuring a personalized and supportive experience for both clients and candidates.

Why Vivian Health?

Be sure to apply via Vivian Health to increase your chances of landing your perfect job. Just complete your Vivian Health profileonce, and get access to thousands of opportunities across the country. Then keep up to date with your job application process and conversations with our easy to use app.

Benefits
  • Medical benefits
  • Dental benefits
  • Company provided housing options
  • Continuing Education

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