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Case Review Officer Jobs in Virginia (NOW HIRING)

Nwis

Information Review & Release Analyst

Sterling, VA · On-site

$77K - $163K/yr

The candidate must be able to successfully apply critical-thinking skills when evaluating each case ... foreign disclosure officers, CD/CI/CT analysts, etc) AND a demonstrated familiarity with the ...

Nwis

Information Review & Release Analyst

Sterling, VA · On-site

$77K - $163K/yr

The candidate must be able to successfully apply critical-thinking skills when evaluating each case ... foreign disclosure officers, CD/CI/CT analysts, etc) AND a demonstrated familiarity with the ...

Nwis

Information Review & Release Analyst

Sterling, VA · On-site

$77K - $163K/yr

The candidate must be able to successfully apply critical-thinking skills when evaluating each case ... foreign disclosure officers, CD/CI/CT analysts, etc) AND a demonstrated familiarity with the ...

Nwis

Information Review & Release Analyst

Sterling, VA · On-site

$77K - $163K/yr

The candidate must be able to successfully apply critical-thinking skills when evaluating each case ... foreign disclosure officers, CD/CI/CT analysts, etc) AND a demonstrated familiarity with the ...

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Case Review Officer information

What is a case review officer?

Case Review Officers are professionals who assess, investigate, and review cases within an organization or government department, often related to compliance, complaints, or claims. Their primary responsibility is to ensure that cases are handled fairly, thoroughly, and in accordance with established policies and regulations. They gather and analyze information, interview relevant parties, and make recommendations or decisions based on their findings. Case Review Officers work in sectors such as social services, insurance, legal, and law enforcement, helping to ensure transparency and accountability in decision-making processes.

What are the key skills and qualifications needed to thrive as a case review officer?

To thrive as a Case Review Officer, you need strong analytical skills, attention to detail, and a background in law, compliance, or a related field. Familiarity with case management systems, legal databases, and sometimes certifications in regulatory compliance or investigation techniques are typically required. Excellent communication, impartial judgment, and the ability to manage sensitive information with discretion are vital soft skills. These competencies ensure accurate and fair case assessments, support organizational integrity, and maintain trust in review processes.

How does a case review officer typically collaborate with other departments during the case assessment process?

Case Review Officers regularly work with departments such as legal, compliance, and operations to ensure cases are evaluated thoroughly and fairly. They often participate in cross-functional meetings, sharing findings and gathering additional information required for accurate decision-making. Effective communication and documentation are key, as Case Review Officers must relay case updates and recommendations to both internal teams and, when appropriate, external partners. This collaborative process helps maintain transparency and consistency in case handling.

What is the difference between Case Review Officer vs Claims Adjuster?

AspectCase Review OfficerClaims Adjuster
Required CredentialsHigh school diploma or equivalent; some roles may require a bachelor's degreeHigh school diploma or equivalent; some roles may require certifications
Work EnvironmentOffice settings, government agencies, insurance companiesOffice settings, insurance companies, fieldwork in some cases
Industry UsageUsed mainly in government, legal, and insurance sectors for case assessmentsPrimarily in insurance industry for evaluating claims and determining payouts

While both roles involve reviewing cases, a Case Review Officer typically focuses on assessing legal or administrative cases within government or insurance settings, whereas a Claims Adjuster primarily evaluates insurance claims to determine coverage and settlement amounts. Understanding these differences helps job seekers identify the right career path based on their skills and interests.

What are popular job titles related to Case Review Officer jobs in Virginia?

For Case Review Officer jobs in Virginia, the most frequently searched job titles are:

What job categories do people searching Case Review Officer jobs in Virginia look for?

The top searched job categories for Case Review Officer jobs in Virginia are:

Case Review Officer jobs near you
Infographic showing various Case Review Officer job openings in Virginia as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, 3% Contract, and 1% Nights. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution.

Nurse Practitioner - Medical Case Review - Springfield, VA

Prime Physicians

Springfield, VA • On-site

$107K - $146K/yr

Contractor

Re-posted 3 days ago

Job description

Prime Physicians is an organization accredited by The Joint Commission (TJC), ISO 9001 certified, and appraised at CMMI Services Level 3. We provide program management support, medical staffing, and medical services to the Department of Veterans Affairs, the Defense Health Agency (Navy, Air Force, and Army), and the Indian Health Service (IHS), along with comprehensive consulting and management solutions to hospitals and health systems. Our singular focus is advancing high-quality patient care.
 
Guided by a mission to drive healthcare transformation and innovation, we offer a full range of services from program and project management to strategic planning that strengthen operational efficiency and streamline business processes. At Prime Physicians, we are committed to building a more efficient, effective, and compassionate healthcare system, ensuring that the future of patient care remains in skilled and dedicated hands.

Job Title: Nurse Practitioner – Medical Case Review
 
Specialty: Occupational Health / Advanced Case Management / Fitness-for-Duty & Complex Medical Determinations
 
Place of Work (City/State): Remote — must reside within local commuting distance Springfield, VA (minimum 1 day per week onsite required after the first month onsite training
 
Duration: One year (options for 6 months contract) + extendable
 
Start Date: October 2026
 
Shift Schedule:
  • Core business hours: Monday–Friday, 9:00 a.m. – 3:00 p.m.
  • First month: onsite training, 8 hours/day
  • Steady state: hybrid remote/onsite, minimum 1 day/week onsite
  • Additional onsite attendance as requested by OCMO (local, non-reimbursable travel)
How Many Shifts Needed Per Month: Approximately 20–22 working days/month
 
License: Active, unrestricted license as a Nurse Practitioner in Virginia, or multistate licensure
 
Certifications: Current NP board certification consistent with MSN/DNP
 
Experience Needed: Minimum 5 years of direct, relevant experience in clinical practice, occupational health, and advanced case management, including experience in medical review, fitness-for-duty evaluations, and review of complex medical determinations
 
Special Skills Needed:
  • Strong clinical judgment for complex/abnormal/non-standard case review
  • Experience with electronic medical record review platforms
  • Strong written documentation skills for case files and determination summaries
  • Ability to meet high-volume production standards and 24-hour response requirements
  • Comfortable coordinating with government clinical leadership (Chief Medical Officer) on escalations
Credentialing / Onboarding Time: Approximately 50 days
 
Responsibilities:
Review and adjudicate TSO applicant and reinstatement medical examination records, issuing pass/fail medical recommendations as part of a team averaging 300 medical recommendations processed per day. Conduct Fitness-for-Duty evaluations and collaborate with the TSA Chief Medical Officer on abnormal, complex, or non-standard cases and complex medical determinations. Support AMC questionnaire reviews, ad hoc FMLA record reviews, and EEO case support (including fact-witness participation, if requested).
 
Misc:
  • Government-Furnished Equipment (GFE) provided
  • NP role is limited to recommendation, documentation, and coordination

Prime Physicians is a physician-led, The Joint Commission (TJC) Accredited, ISO 9001 certified and CMMI Level 3 appraised organization. Our commitment extends beyond traditional consulting and management services, offering comprehensive solutions to hospitals, health systems, and federal government agencies. At the heart of our operations is the ultimate goal to deliver high-quality patient care. Driven by a mission to catalyze healthcare transformation and innovation, we offer an array of services designed to redefine the healthcare landscape. From program and project management to strategic planning, we enhance operational efficiency and streamline business processes. With Prime Physicians, the future of patient care is in skilled and dedicated hands, leading the way towards a more efficient, effective, and compassionate healthcare system.