ZipRecruiter

Log In

2

Director Remote Utilization Review Jobs in Silver Spring, MD

next page

Showing results 1-20

All JobsUtilization Review JobsDirector Remote Utilization Review JobsDirector Remote Utilization Review Jobs in Silver Spring, MD

Director Remote Utilization Review information

See Silver Spring, MD salary details

$22

$43

$71

How much do director remote utilization review jobs pay per hour?

As of Aug 22, 2026, the average hourly pay for director remote utilization review in Silver Spring, MD is $43.71, according to ZipRecruiter salary data. Most workers in this role earn between $34.52 and $50.19 per hour, depending on experience, location, and employer.

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 cities near Silver Spring, MD are hiring for Director Remote Utilization Review jobs?

Cities near Silver Spring, MD with the most Director Remote Utilization Review job openings:

Director Remote Utilization Review jobs near you

Utilization Review, RN Flex

University of Maryland Medical System

Towson, MD • Remote

Full-time

Posted 3 days ago

New

Job description

Job Requirements
  • Weekend only position. 
  • 4 - eight hour weekend shifts a month required. 
  • At least 1 major holiday required.
  • Only serious applicants should apply. 
  • Recent UR / MCG experience.
  • Most of the training will be remote however you will be required to start onsite

A Utilization Review (UR) Nurse is a registered nurse who bridges the gap between healthcare providers and insurance companies. They evaluate patient medical records to ensure treatments, procedures, and hospital stays are clinically necessary, cost-effective, and meet established insurance guidelines.

  • Medical Necessity Reviews: They verify that admissions, surgeries, and treatments are medically necessary by comparing patient charts to standardized, evidence-based guidelines like Milliman Care Guidelines (MCG) or InterQual.
  • Concurrent & Retrospective Reviews: They review ongoing hospital stays (concurrent) to authorize continuing care, and review charts after discharge (retrospective) to prevent claim denials and ensure accurate billing.
  • Insurance Liaison: They act as a go-between, submitting clinical data to insurance companies to secure prior authorizations and ongoing approvals so the hospital gets properly reimbursed.
  • Resource Optimization: They monitor the patient's progress to ensure they are in the appropriate level of care (e.g., observation vs. inpatient) and help coordinate discharges to lower levels of care.

Work Experience

Education

* 4 year/ Bachelor's degree in Nursing (Required)

Master's Degree in Nursing (Preferred)

Experience and Skills

Recent UR / MCG experience.

Required Skills: Strong Verbal Communications Skills, Strong Written Communications Skills, Excel Intermediate Level, PowerPoint - Intermediate Level, MS Word - Intermediate Level, Excellent Organizational Skills


Employment Type: OTHER

Apply