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Case Reviewer Jobs in Washington (NOW HIRING)

Constellis

Case Reviewer

VA · On-site

Review case work and provide feedback regarding quality and completeness * Contact Field Investigators regarding cost and quality exceptions with their work. * Monitor pending cases to ensure ...

Constellis

Case Reviewer

VA · On-site +1

Review case work and provide feedback regarding quality and completeness * Contact Field Investigators regarding cost and quality exceptions with their work. * Monitor pending cases to ensure ...

Constellis

Case Reviewer - DHS

VA · On-site +1

Review case work and provide feedback regarding quality and completeness * Contact Field Investigators regarding cost and quality exceptions with their work. * Monitor pending cases to ensure ...

Constellis

Case Reviewer - DHS

VA

Review case work and provide feedback regarding quality and completeness * Contact Field Investigators regarding cost and quality exceptions with their work. * Monitor pending cases to ensure ...

LAUKOA

Registered Nurse Case Manager

Alexandria, VA · On-site

$82K - $97K/yr

As a RN Case Manager (also known as a Permanent Case Reviewer) [PCR], you will provide the services of Medical Case Management in support of Individual Medical Readiness to the Army Reserve Medical ...

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Case Reviewer information

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$21

$53

$90

How much do case reviewer jobs pay per hour?

As of Aug 12, 2026, the average hourly pay for case reviewer in Washington is $53.84, according to ZipRecruiter salary data. Most workers in this role earn between $40.00 and $65.05 per hour, depending on experience, location, and employer.

How to get a job as a case reviewer?

To become a case reviewer, candidates typically need a background in healthcare, social work, or legal fields, along with strong analytical and communication skills. Relevant experience, attention to detail, and familiarity with case management systems or documentation are often required, and some positions may require certification or training in specific areas.

What are the key skills and qualifications needed to thrive in the case reviewer position, and why are they important?

To thrive as a Case Reviewer, you need strong analytical abilities, attention to detail, and a background in the relevant industry, often supported by a degree in law, healthcare, or a specialized field. Familiarity with case management software, electronic records systems, or regulatory databases is usually important, and certifications may be required for specialized roles. Excellent written communication, impartiality, and time management are soft skills that set top performers apart. Mastery of these skills ensures accurate, timely case evaluations and effective collaboration with stakeholders for informed decision-making.

What is a case reviewer?

A Case Reviewer is responsible for evaluating case files, documents, and related information to ensure accuracy, compliance, and completeness. They analyze evidence, verify facts, and provide detailed assessments based on established guidelines or legal standards. Case Reviewers often work in legal, medical, insurance, or government sectors and must have strong attention to detail and analytical skills. Their role helps ensure fair and accurate decision-making in various professional settings.

What are the typical daily responsibilities of a case reviewer?

As a Case Reviewer, your day-to-day work commonly involves reviewing case files, supporting documents, and related evidence to assess compliance with relevant guidelines or policies. You may be required to write detailed reports, summarize findings, and make recommendations based on established criteria. Collaboration is frequent, as you often interact with other reviewers, supervisors, and subject matter experts to discuss complex cases or clarify information. This role demands a high level of organization and consistency, as accuracy and fairness are critical when determining outcomes that impact clients, patients, or other stakeholders.

What does a case reviewer do?

A case reviewer evaluates and analyzes cases, such as insurance claims, legal matters, or healthcare records, to ensure accuracy, completeness, and compliance with policies. They often review documentation, make determinations, and document findings, using attention to detail and sometimes specialized software or guidelines.
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What cities in Washington are hiring for Case Reviewer jobs? Cities in Washington with the most Case Reviewer job openings:
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Case Reviewer jobs near you
Infographic showing various Case Reviewer job openings in Washington as of August 2026, with employment types broken down into 75% Full Time, 13% Part Time, and 12% Contract. Highlights an 80% In-person, 4% Hybrid, and 16% Remote job distribution, with an average salary of $111,978 per year, or $53.8 per hour.

Case Reviewer

Absolute Staffing and Consulting Solutions

Columbia, MD • Hybrid

$23 - $27/hr

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

Case Reviewer

Absolute Staffing & Consulting Solutions is looking for a Case Reviewer to join our team of professionals. This is a hybrid role in Maryland.

As a Case Reviewer, you will be responsible for performing utilization reviews to authorize services for individuals enrolled in Medicaid. The utilization review process involves applying program policies, verifying medical, technical, and financial eligibility, and reviewing medical records to issue decisions regarding pre-authorization of services.

Essential Functions

  • Provides review decisions for prospective reviews based on an established set of criteria.
  • Screens situations according to specific criteria to determine if care is appropriate.
  • Refers cases that fail to meet criteria to a Registered Nurse or Social Worker reviewer.
  • Ensures review is conducted thoroughly and within specified timeframes.
  • Serves as liaison among clinical reviewer, provider, facility, and/or subscriber.
  • Documents medical information supporting decisions into the workflow documentation system, ensuring data is entered accurately and timely.
  • Ensures quality customer service by responding to email and phone inquiries from providers and consumers.

Requirements

  • Bachelor's degree in the health or human services and at least 1 year of experience in utilization review or 1 year of experience evaluating, analyzing, researching and developing health care services, policies and programs preferred OR
  • A high school diploma or equivalent may substitute for a bachelor's degree with at least 3 years of experience in utilization review or 3 years of experience evaluating, analyzing, researching and developing health care services, policies and programs.
  • Demonstrated ability working with confidential information and in a deadline-driven environment.
  • Excellent verbal and written communication skills
  • Comfortable with completing basic math functions.
  • Attention to detail, analytical skills, and the ability to interpret medical documentation accurately.
  • Possess intermediate PC skills including navigating electronic health records and other computer software.
  • Ability to work independently and as part of a team.
  • Organizational skills and time management.
  • Experience in a community health care environment preferred.
  • Experience with utilization review of medical services preferred.
  • Satisfactory completion of medical terminology course preferred.
  • Preferably reside in the state of Maryland

Preferred Skills and Certifications

  • Proficiency with Sharepoint
  • Possess intermediate skills in Excel
  • Strong analytical and critical thinking skills
  • Previous support planner experience a plus

Shift: Monday - Friday from 8 am-5 pm EST

Base Pay: $23- $27/ hour

Why work for our client?

Our client is one of the country's most respected population health management organizations. They work with state and federal government programs, as well as employers and health plans offering clinical, analytical, and technical expertise.

Health has changed a lot through our 50-year history, but what has remained constant is that they care deeply about who they serve and what they do. Their success is built on their ability to adapt, respond to client needs, and offer innovative solutions at every turn.

Our client is looking for talented individuals who not only believe in the mission, but who are ready to take ownership and make a difference in the lives of people, in the world of health.

Apply