2

Remote Optum Clinical Review Jobs in Silver Spring, MD

Remote JobDuration: Contract / FTE Client: Federal Criteria-Need US citizenshipbecause of federal ... Utilization Management / Utilization Review / Prior Authorization * Clinical or healthcare ...

Remote Job Duration: Contract / FTE Client: Federal Criteria- Need US citizenship because of ... Utilization Management / Utilization Review / Prior Authorization * Clinical or healthcare ...

Showing results 41-60

Remote Optum Clinical Review information

See Silver Spring, MD salary details

$14

$35

$93

How much do remote optum clinical review jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for remote optum clinical review in Silver Spring, MD is $35.79, according to ZipRecruiter salary data. Most workers in this role earn between $17.16 and $34.04 per hour, depending on experience, location, and employer.

What is a Remote Optum Clinical Review?

A Remote Optum Clinical Review is a job where healthcare professionals, such as nurses or physicians, evaluate medical records and treatment plans from a remote location. The goal is to ensure that healthcare services and procedures meet established clinical guidelines and are medically necessary. These reviews help determine coverage decisions for insurance claims and improve patient outcomes. Team members work from home, using secure systems to review documentation and collaborate with clinicians or insurance representatives. Optum is a part of UnitedHealth Group, and their clinical reviewers play a key role in maintaining quality and compliance in healthcare delivery.

How does a Remote Optum Clinical Review professional typically collaborate with interdisciplinary teams while working from home?

Remote Optum Clinical Review professionals frequently collaborate with physicians, nurses, case managers, and other healthcare staff through virtual meetings, secure messaging, and shared electronic health records. Effective communication skills are essential, as most interactions are conducted remotely. Team members regularly participate in cross-functional discussions to review patient cases, ensure compliance with clinical guidelines, and make evidence-based recommendations. Despite working from home, there is a strong emphasis on teamwork and maintaining alignment with organizational goals and regulatory standards.

What are the key skills and qualifications needed to thrive as a Remote Optum Clinical Review nurse, and why are they important?

To thrive as a Remote Optum Clinical Review Nurse, you need a valid RN license, strong clinical judgment, and experience in utilization management or case review. Familiarity with clinical review software, electronic health records (EHRs), and knowledge of medical necessity criteria like MCG or InterQual is typically required. Excellent attention to detail, critical thinking, and effective communication are key soft skills for evaluating cases and collaborating with healthcare teams. These skills ensure accurate clinical assessments, compliance with regulations, and improved patient care outcomes in a remote environment.

What is the difference between Remote Optum Clinical Review vs Remote Optum Utilization Review?

AspectRemote Optum Clinical ReviewRemote Optum Utilization Review
CertificationsRN, LPN, or other clinical licensesRN, LPN, or other clinical licenses
Work EnvironmentHome-based, healthcare settingHome-based, healthcare setting
Employer & IndustryOptum, healthcare insurance and managed careOptum, healthcare insurance and managed care
Primary FocusAssessing clinical necessity and appropriateness of careReviewing medical necessity for insurance coverage

Both roles involve remote work within the healthcare insurance industry, requiring clinical licenses. The main difference is that Clinical Review focuses on evaluating the appropriateness of care, while Utilization Review emphasizes determining medical necessity for insurance purposes.

What are popular job titles related to Remote Optum Clinical Review jobs in Silver Spring, MD?

For Remote Optum Clinical Review jobs in Silver Spring, MD, the most frequently searched job titles are:

What job categories do people searching Remote Optum Clinical Review jobs in Silver Spring, MD look for?

The top searched job categories for Remote Optum Clinical Review jobs in Silver Spring, MD are:

What cities near Silver Spring, MD are hiring for Remote Optum Clinical Review jobs?

Cities near Silver Spring, MD with the most Remote Optum Clinical Review job openings:

Infographic showing various Remote Optum Clinical Review job openings in Silver Spring, MD as of August 2026, with employment types broken down into 57% Full Time, 32% Part Time, and 11% Contract. Highlights an 100% Remote job distribution, with an average salary of $74,434 per year, or $35.8 per hour.

Medical Device Workflow & Validation Lead (Remote, Continental United States)

ICA.ai

Arlington, VA โ€ข On-site, Remote

$130K - $160K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 5 days ago


Key responsibilities

  • Build strong working relationships with client reviewers and establish a regular, structured feedback process.

  • Lead discovery and validation sessions using prototypes and working software.

  • Validate proposed requirements and workflows before development begins.


Job description

About ICA, Inc.

ICA, Inc. is a rapidly growing company, located in the D.C./Metro area. We were founded in 2009 to assist government clients with evaluating and achieving their objectives. We have become a trusted advisor helping our clients by offering cutting-edge innovation and solutions to complex projects. Our small company has grown significantly, and we're overjoyed at the opportunity to expand yet again!

We are results-focused and have a proven track record supporting federal agencies and large government services primes in three main areas: Research and Data Analysis, Advanced-Data Science, and Strategic Services. We currently support multiple analytics and research programs across HHS.

At ICA, we believe our success starts with our people. We foster a collaborative "one team" environment where work-life balance isn't just talked about - it's prioritized. We're building dynamic, highly skilled teams in a welcoming and supportive atmosphere. If you're passionate about using your technical expertise to make a difference, we want to talk to you.

We are looking for a Medical Device Workflow & Validation Lead to join our growing team!

ABOUT THE ROLE:

We are hiring a Medical Device Workflow & Validation Lead that helps to represent the reviewer's perspective across our document intelligence platform, including product development and client delivery. You will help us understand how reviewers work, translate their needs into clear requirements, validate features from a domain perspective, and lead client demonstrations and user acceptance. This role is responsible for ensuring that alerts, evidence, and workflows provide genuine value without creating unnecessary reviewer burden or presenting automated findings as regulatory conclusions

KEY RESPONSIBILITIES:

  • Build strong working relationships with client reviewers and establish a regular, structured feedback process.
  • Lead discovery and validation sessions using prototypes and working software.
  • Translate reviewer needs into workflows, business rules, user stories, and measurable acceptance criteria.
  • Validate proposed requirements and workflows before development begins.
  • Partner with the Senior Product Manager to ensure requirements are accurate from a medical-device review perspective.
  • Define meaningful alert categories, priorities, reviewer actions, and escalation paths.
  • Evaluate alert relevance, false positives, false negatives, evidence quality, usability, and reviewer effort.
  • Test completed capabilities from a reviewer's perspective and identify missing requirements, confusing behavior, unsupported conclusions, and workflow gaps.
  • Lead client demonstrations, user acceptance testing, feedback capture, and acceptance or signoff.
  • Maintain traceability from the original client's needs through requirements, validation, and approval.
  • Improve domain understanding across product, engineering, data science, and leadership teams.

REQUIRED QUALIFICATIONS:

  • Previous experience as a medical-device reviewer with experience in medical-device regulatory review, regulatory affairs, quality assurance, clinical review, or related regulated-document field.
  • Strong understanding of medical-device submission documentation and review processes.
  • Experience gathering requirements and working directly with clients, reviewers, or other domain stakeholders.
  • Ability to translate complex domain needs into clear, testable product requirements.
  • Experience conducting user acceptance testing or structured software validation.
  • Ability to identify missing evidence, unsupported conclusions, workflow gaps, and unintended consequences.
  • Strong analytical, facilitation, documentation, and communication skills.
  • Credibility and confidence when working with client domain experts.
  • Comfort collaborating with product managers, engineers, data scientists, and UX teams.
  • Must be authorized to work in the United States and have lived in the US for 3 or more consecutive years.
  • Must be able and willing to obtain a Public Trust Clearance

USE OF AI ASSITIVE TECHNOLOGY

All application materials must be your own original work, and interviews must be completed independently. Use of AI-generated content in applications or AI assistance during interviews will result in disqualification.

BENEFITS:

We invest in our team members so you can live your best life professionally and personally, offering a competitive salary and benefits.

  • Health Insurance -100% employer-paid premiums - ICA covers the full cost of one of three offered medical plans
  • Dental Insurance
  • Vision insurance
  • Health Spending Account
  • Flexible Spending Account
  • Life and Disability insurance
  • 401(k) plan with company match
  • Paid Time Off (Vacation, Sick Leave and Holidays)
  • Education and Professional Development Assistance
  • Remote work from anywhere within the continental United States

LOCATION & TELEWORK
This is a remote position following Eastern Standard Time (EST). Candidates residing in the DMV area preferred.

ADDITIONAL INFORMATION:

ICA is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender, gender identity or expression, national origin, genetics, disability status, protected veteran status, age, or any other characteristic protected by state, federal or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

Employment Type: FULL_TIME