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Online Utilization Review Jobs in Silver Spring, MD

Prime Time Healthcare

Utilization Review

Baltimore, MD · On-site

Now Hiring: RN Utilization Review - Baltimore, MD Are you a passionate RN professional looking for a new adventure? Prime Time Healthcare is seeking dynamic individuals like you to join our team in ...

Prime Time Healthcare

Utilization Review

Washington, DC · On-site

Now Hiring: RN Utilization Review - Washington, DC Are you a passionate RN professional looking for a new adventure? Prime Time Healthcare is seeking dynamic individuals like you to join our team in ...

UHS

Utilization Review Coordinator

Washington, DC · On-site

Six months psychiatric utilization review either for hospital or external review organization preferred. * Candidates must meet the company's hiring criteria to include a pre-employment verifications ...

UHS

Utilization Review Coordinator

Washington, DC · On-site

Six months psychiatric utilization review either for hospital or external review organization preferred. * Candidates must meet the company's hiring criteria to include a pre-employment verifications ...

UHS

Utilization Review Coordinator

Washington, DC · On-site

$33.60 - $50.40/hr

Six months psychiatric utilization review either for hospital or external review organization preferred. * Candidates must meet the company's hiring criteria to include a pre-employment verifications ...

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Online Utilization Review information

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$22

$43

$71

How much do online utilization review jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for online 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 an online utilization review?

An Online Utilization Review is a process in which healthcare professionals evaluate the necessity, efficiency, and appropriateness of medical services, procedures, or hospital admissions using digital platforms. This review is typically conducted remotely, using electronic health records and online communication tools to assess patient care. The goal is to ensure that patients receive the most effective care while avoiding unnecessary treatments and controlling healthcare costs. Online Utilization Review professionals may work for hospitals, insurance companies, or third-party administrators to maintain quality standards and compliance with regulations.

What are the key skills and qualifications needed to thrive as an online utilization review specialist?

To thrive as an Online Utilization Review Specialist, you need a solid background in nursing or healthcare, with credentials such as an RN or LPN license and experience in clinical review processes. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of insurance guidelines and medical necessity criteria are typically required. Strong analytical thinking, attention to detail, and clear written communication help you effectively assess cases and interact with healthcare providers. These skills ensure accurate case reviews, compliance with regulations, and optimal patient care while controlling healthcare costs.

What are some common challenges faced by professionals in online utilization review, and how can they be addressed?

One common challenge in Online Utilization Review is staying up-to-date with changing regulations and payer requirements, which can impact approval criteria and documentation standards. Another challenge is effectively managing a high volume of cases while maintaining accuracy and meeting turnaround times. Building strong communication skills for collaborating with providers and interdisciplinary teams is also crucial. To address these challenges, professionals often participate in ongoing training, utilize clinical decision support tools, and foster open communication with team members and stakeholders.

What is the difference between Online Utilization Review vs Utilization Review Coordinator?

AspectOnline Utilization ReviewUtilization Review Coordinator
CredentialsTypically requires healthcare or insurance certifications, such as RN, CPC, or CCMOften requires similar certifications, with additional administrative or coordination training
Work EnvironmentRemote or office-based, reviewing patient records and insurance claims onlineOffice setting, coordinating reviews and communicating with providers and patients
Employer & IndustryHospitals, insurance companies, healthcare organizationsInsurance companies, healthcare facilities, third-party review agencies

Online Utilization Review involves assessing medical necessity and coverage remotely using digital records, while Utilization Review Coordinator manages the review process, coordinating between providers and insurers. Both roles require similar credentials and are integral to healthcare and insurance industries, but Online Utilization Review is more focused on remote case assessments, whereas the Coordinator handles administrative oversight.

How do I get into an online utilization review?

To become an online utilization review specialist, you typically need a healthcare-related degree such as nursing, health administration, or a related field, along with knowledge of insurance policies and medical terminology. Certification in utilization review or case management, like the Certified Professional in Healthcare Quality (CPHQ), can improve job prospects. Relevant skills include strong analytical abilities, attention to detail, and familiarity with electronic health records and review software.

What are the most commonly searched types of Utilization Review jobs in Silver Spring, MD?

The most popular types of Utilization Review jobs in Silver Spring, MD are:

What are popular job titles related to Online Utilization Review jobs in Silver Spring, MD?

For Online Utilization Review jobs in Silver Spring, MD, the most frequently searched job titles are:

What job categories do people searching Online Utilization Review jobs in Silver Spring, MD look for?

The top searched job categories for Online Utilization Review jobs in Silver Spring, MD are:

What cities near Silver Spring, MD are hiring for Online Utilization Review jobs?

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

Online Utilization Review jobs near you

Utilization Review

Prime Time Healthcare

Baltimore, MD • On-site

Other

Medical, Dental, Vision, Retirement

Re-posted 4 days ago

Job description

Now Hiring: RN Utilization Review - Baltimore, MD

Are you a passionate RN professional looking for a new adventure? Prime Time Healthcare is seeking dynamic individuals like you to join our team in Baltimore, MD and make a real impact in patient care!

In this role, you'll be at the forefront of healthcare, delivering top-notch care with precision and compassion. As an integral part of our team, you'll collaborate closely with fellow healthcare professionals, ensuring every patient receives the highest level of care possible.

If you're ready to elevate your career and make a difference in the lives of others, apply today!

At Prime Time Healthcare, We Offer Competitive Compensation Along With A Large Range Of Benefits Including:
  • Competitive compensation and weekly direct deposit
  • Compliance support specialist & onboarding assistance
  • Dedicated recruiter for personalized support
  • Paid, safe, pet-friendly lodging (if applicable)
  • Round-the-clock customer support 24/7
  • Unlimited referral bonus up to $750
  • Medical, vision & dental insurance
  • 401(k) matching program
  • Flexible schedules
  • Travel discounts

Prime Time Healthcare, LLC is an equal opportunity employer (EOE).

*Estimated pay and benefits packages are on a per facility basis and may change with market conditions. Exact pay and benefits package will be negotiated with Prime Time Healthcare and may vary with several factors including but not limited to, guaranteed hours, travel distance, demand, eligibility, etc.

PrimeTime Healthcare logo

About PrimeTime Healthcare

Sourced by ZipRecruiter

PrimeTime Healthcare, based in Omaha, NE, US, is a leading provider of staffing solutions in the healthcare industry. According to information accessed from their official website, primetimehealthcare.com, the company specializes in placing high-quality healthcare professionals into temporary and travel positions across a vast network of healthcare facilities nationwide. Founded in 2012, PrimeTime Healthcare quickly established a reputation for customer-focused and result-oriented services, earning it a place on Staffing Industry Analyst’s fastest-growing staffing companies list.

Industry

Recruiting and staffing services

Company size

51 - 200 Employees

Headquarters location

Omaha, NE, US

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