ZipRecruiter

Log In

2

Director Remote Utilization Review Jobs in Virginia

BayNova LLC

Director, Growth

Arlington, VA · On-site +1

This is a remote position. Role Priorities While this position contributes across multiple aspects ... Coordinate color team reviews (Pink, Red, Gold, White Glove) and ensure timely incorporation of ...

TalentRemedy

Director, SEC Reporting

Herndon, VA · On-site +1

$185K - $240K/yr

Location: Herndon, VA - Remote Fridays and flexible commute times Compensation: base $185,000 ... Own the preparation, review, and filing of Forms 10-K, 10-Q, 8-K, and proxy statements, ensuring ...

Novartis

$185K - $344K/yr

Summary #LI-Remote Lead the strategy and evolution of external expert engagement across the ... be reviewed periodically. Novartis may change the published salary range based on company and ...

Maximus

Senior Director - Capture Management

VA · On-site +1

... City Remote Country United States Working time Full-time Description & Requirements Maximus is ... Plan Review through Final Bid Decision, working closely with the National Security Business ...

Sparks Group

Federal Sales Director

Vienna, VA · On-site +1

Participate in pipeline reviews, territory planning, and quarterly business reviews while providing ... Proficiency with Salesforce or similar CRM platforms. ----- This job is Hybrid Remote. We offer ...

previous page

Showing results 41-60

All JobsUtilization Review JobsDirector Remote Utilization Review JobsDirector Remote Utilization Review Jobs in Virginia

Director Remote Utilization Review information

What is a director of remote utilization review?

A Director of Remote Utilization Review is a healthcare leader responsible for overseeing teams that assess the necessity, appropriateness, and efficiency of medical services, typically from a remote or virtual environment. This role ensures compliance with regulatory guidelines, optimizes resource use, and helps manage healthcare costs while maintaining quality patient care. Directors collaborate with physicians, nurses, and insurance providers to review clinical cases and develop utilization review strategies. They also monitor performance metrics and implement process improvements for remote teams.

How does a director of remote utilization review typically collaborate with clinical and administrative teams to ensure effective patient care management?

A Director of Remote Utilization Review plays a pivotal role in bridging clinical staff, case managers, and administrative teams to optimize patient care and resource utilization. This is often achieved through regular virtual meetings, data sharing, and cross-departmental strategy sessions to review utilization trends and address barriers to care. The director ensures that remote teams adhere to regulatory standards and organizational goals, fostering open communication to streamline workflows and resolve complex cases efficiently. Successful collaboration enhances patient outcomes, reduces unnecessary costs, and maintains compliance, all while supporting a positive remote team environment.

What are the key skills and qualifications needed to thrive as a director of remote utilization review, and why are they important?

To thrive as a Director of Remote Utilization Review, you need in-depth knowledge of healthcare regulations, utilization management processes, and a relevant clinical background, typically supported by an RN or other clinical licensure and experience in case management. Familiarity with utilization review software, electronic health records (EHR), and certifications such as CCM or UM are often required. Leadership, analytical thinking, and strong communication skills are vital for guiding teams and collaborating with stakeholders. These skills ensure effective oversight of remote teams, regulatory compliance, and optimal patient care outcomes.

What is the difference between Director Remote Utilization Review vs Utilization Review Nurse?

AspectDirector Remote Utilization ReviewUtilization Review Nurse
CredentialsTypically requires a nursing license, advanced degree, and management experienceRegistered Nurse (RN) license, relevant clinical experience
Work EnvironmentOversees teams remotely, strategic planning, policy developmentConducts patient reviews, collaborates with healthcare providers, often remote or onsite
Employer & Industry UsageHealth insurance companies, managed care organizationsHospitals, insurance companies, healthcare facilities

The main difference is that the Director Remote Utilization Review focuses on managing teams and policies remotely, while the Utilization Review Nurse performs clinical reviews directly related to patient care. The director has a broader strategic role, whereas the nurse role is more clinical and operational.

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

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

What cities in Virginia are hiring for Director Remote Utilization Review jobs?

Cities in Virginia with the most Director Remote Utilization Review job openings:

Director Remote Utilization Review jobs near you
Infographic showing various Director Remote Utilization Review job openings in Virginia as of August 2026, with employment types broken down into 91% Full Time, and 9% Part Time. Highlights an 100% Remote job distribution.

Director, Growth

BayNova LLC

Arlington, VA • On-site, Remote

Full-time

Re-posted 12 days ago

Job description

The Director, Growth will be responsible for leading BayNova's end-to-end Federal proposal development lifecycle while serving as a key leader within the company's growth organization. This role will ensure BayNova consistently submits high-quality, compliant, and compelling proposals while helping mature the people, processes, tools, and content that support sustainable business growth across Federal Civilian, Health, and DoW markets.
Proposal leadership is the primary responsibility of this role and represents the company's highest growth priority. The Director, Growth is expected to balance broader growth initiatives with the timely delivery of winning proposals, ensuring proposal excellence remains the primary focus of the role.
The Director, Growth works closely with executive leadership, BD/Capture/Sales, technical subject matter experts, delivery teams, partners, and subcontractors to translate customer requirements into winning proposals. Beyond proposal leadership, the role contributes to capture planning, market research, marketing initiatives, customer engagement planning, corporate capabilities development, and continuous improvement of the company's growth processes.
This position reports directly to executive leadership and plays a critical role in achieving the company's strategic growth objectives.
This is a remote position.
Role Priorities
While this position contributes across multiple aspects of the company's growth organization, responsibilities are prioritized as follows:
  1. Lead the successful development and submission of winning proposals.
  2. Develop and mature the proposal infrastructure, tools, reusable content, and processes that improve long-term growth effectiveness.
  3. Support business development, capture, marketing, and delivery activities where those efforts directly strengthen active pursuits or position the company for future opportunities.

As the company grows, the scope of this role may expand to include broader ownership of growth operations and/or leadership of additional growth personnel.
Key Responsibilities
Proposal Leadership (Primary Responsibility)
  • Lead the complete proposal lifecycle (RFIs, Sources Soughts, RFP, RFQs, etc.) from opportunity qualification through submission and post-submission lessons learned
  • Write Technical, Management, Past Performance and other sections as needed to respond to customer requirements
  • Develop proposal schedules, compliance matrices, outlines, storyboards, and production plans.
  • Manage proposal teams consisting of technical/delivery staff, pricing, contracts, recruiting, and executive leadership.
  • Drive proposal strategy, win themes, discriminators, messaging, and customer-focused content.
  • Ensure proposal compliance with solicitation requirements, evaluation criteria, and submission instructions.
  • Coordinate color team reviews (Pink, Red, Gold, White Glove) and ensure timely incorporation of reviewer feedback.
  • Oversee proposal production, quality assurance, formatting, graphics coordination, and final submission.
  • Maintain proposal repositories, templates, boilerplate content, resumes, past performance libraries, and proposal knowledge management assets.
  • Analyze proposal metrics and implement continuous process improvements to increase proposal quality and win rates.

Business Development & Capture Support
  • Partner with business development personnel to qualify opportunities aligned with company strategy.
  • Assess opportunities posted to eBuy, SAM.gov, etc. and provide pursuit recommendations.
  • Participate in bid/no-bid decisions.
  • Support capture planning activities including competitive analysis, customer research, teaming strategies, and win strategy development.
  • Assist in developing executive summaries, capability statements, and customer presentation materials.
  • Coordinate with teaming partners throughout capture and proposal efforts.
  • Help maintain visibility into the opportunity pipeline to support proposal planning and resource forecasting.

Marketing & Corporate Communications
  • Collaborate on the development of corporate capabilities materials, solution briefs, white papers, case studies, and other customer-facing content.
  • Support marketing initiatives that directly enable business development and proposal efforts. Ownership of broader corporate marketing activities may reside elsewhere within the organization as the company grows.
  • Help maintain corporate messaging, differentiators, and solution positioning.
  • Coordinate announcements related to contract awards, certifications, partnerships, and company achievements, as appropriate.

Delivery & Operations Collaboration
  • Coordinate with delivery leadership to identify reusable technical content, past performance, and staffing resources.
  • Capture lessons learned from project execution to strengthen future proposals.
  • Support transition activities between proposal and program startup when required.
  • Assist with customer presentations, oral proposals, and technical demonstrations.

Growth Process Management
  • Continuously improve the company's proposal and growth processes, templates, tools, and knowledge repositories, prioritizing initiatives that directly improve proposal quality, efficiency, and win probability.
  • Track key growth metrics including proposal throughput, submission quality, win rate, and proposal resource utilization.
  • Develop and maintain reusable proposal assets, including templates, graphics, standard language, proposal checklists, and knowledge repositories.
  • Own the company's past performance repository, resume library, and proposal content management strategy.
  • Evaluate and implement AI-assisted proposal development tools and workflows that improve proposal quality and team productivity.
  • Recommend process improvements and automation opportunities that enhance the efficiency and effectiveness of proposal operations.
  • Support strategic planning and annual growth initiatives.

Qualifications
Required
  • Bachelor's degree or equivalent professional experience.
  • 8+ years of experience supporting Federal Government proposal management, capture, business development, or growth operations.
  • Demonstrated success leading complex Federal proposals under FAR-based procurements.
  • Strong understanding of Federal proposal best practices, compliance management, and proposal review methodologies.
  • Experience supporting opportunities across Federal Civilian agencies and/or the Department of Defense.
  • Excellent written, editing, and verbal communication skills.
  • Exceptional organizational and project management skills with the ability to manage multiple concurrent priorities.
  • Strong leadership and collaboration skills with cross-functional teams.
  • Proficiency with Microsoft Office and proposal collaboration tools.

Preferred
  • APMP Foundation, Practitioner, or Professional Certification.
  • Experience supporting digital modernization, low-code platforms, AI, cloud, cybersecurity, or enterprise IT services.
  • Experience with GSA MAS, GWACs, BPAs, IDIQs, and task order competitions.
  • Familiarity with Shipley proposal methodologies.
  • Experience supporting oral presentations and demonstrations.
  • Experience implementing AI-assisted proposal development or knowledge management solutions.

Desired Characteristics
The successful candidate is both a strategic thinker and a hands-on executor who enjoys building repeatable processes while delivering exceptional proposals under demanding deadlines. They thrive in an entrepreneurial environment, are comfortable wearing multiple hats, and understand how to balance immediate revenue-generating priorities with longer-term investments in growth capabilities.
They are collaborative, highly organized, customer-focused, and continuously seek opportunities to improve the effectiveness of the company's growth organization through better processes, tools, content, and teamwork.
Success Measures
Success in this role will be measured by:
  • Consistent delivery of high-quality, compliant, and compelling proposals submitted on time.
  • Increased proposal win rates and overall proposal effectiveness.
  • Continuous improvement of proposal operations, reusable assets, and growth infrastructure.
  • Effective collaboration across business development, capture, delivery, marketing, and executive leadership.
  • Development of scalable proposal processes and AI-enabled capabilities that improve efficiency over time.
  • Meaningful contributions to the company's long-term growth strategy while maintaining proposal excellence as the highest operational priority.

Apply