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Remote Optum Utilization Review Jobs in Virginia

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Remote Optum Utilization Review information

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

AspectRemote Optum Utilization ReviewRemote UnitedHealthcare Utilization Review
CredentialsLicenses in relevant states, certifications like CCM or CRC often preferredLicenses in relevant states, certifications like CCM or CRC often preferred
Work EnvironmentRemote, home-based with flexible hoursRemote, home-based with flexible hours
Employer & IndustryOptum, healthcare services and utilization managementUnitedHealthcare, health insurance and utilization review

Both roles involve reviewing healthcare claims and authorizations remotely, requiring similar credentials and work environments. The main difference lies in the employer and specific healthcare focus: Optum specializes in healthcare services and utilization management, while UnitedHealthcare focuses on health insurance and claims review. Candidates often compare these roles to determine the best fit based on employer and industry specialization.

How does a Remote Optum Utilization Review nurse typically collaborate with multidisciplinary teams while working from home?

As a Remote Optum Utilization Review nurse, collaboration with multidisciplinary teams is primarily conducted through secure digital platforms, including video calls, emails, and electronic health record systems. You’ll regularly communicate with physicians, social workers, case managers, and other healthcare providers to review patient cases, coordinate care plans, and ensure compliance with clinical guidelines. Despite working remotely, maintaining clear and timely communication is essential for effective patient advocacy and decision-making. Team meetings and case discussions are scheduled virtually, fostering a supportive environment and ensuring you stay connected to the broader healthcare team.

What is a Remote Optum Utilization Review?

A Remote Optum Utilization Review position involves working for Optum, a healthcare services company, to evaluate medical records and determine the necessity and appropriateness of healthcare services. Employees in this role review clinical documentation to ensure that treatments meet established guidelines and help to manage healthcare costs while ensuring patient care is not compromised. The position is remote, meaning you can work from home or another location outside of a traditional office. Utilization review professionals often interact with healthcare providers, insurance companies, and patients, using their clinical expertise to make informed decisions.

What are the key skills and qualifications needed to thrive as a Remote Optum Utilization Review nurse?

To thrive as a Remote Optum Utilization Review Nurse, you need a current RN license, strong clinical judgment, knowledge of utilization management, and experience in case review or discharge planning. Proficiency with medical review software, electronic health records, and familiarity with UM guidelines such as InterQual or Milliman is typically required. Exceptional communication, attention to detail, and critical thinking are vital soft skills for effective collaboration and decision-making in a remote environment. These skills ensure accurate assessments, regulatory compliance, and optimal patient outcomes while maintaining efficiency in a virtual workflow.
What are the most commonly searched types of Optum Utilization Review jobs in Virginia? The most popular types of Optum Utilization Review jobs in Virginia are:
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Senior Program Finance Analyst

Iridium Satellite, LLC

Mclean, VA • Remote

$86K - $107K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 16 days ago


Job description

Iridium is an award-winning and innovative satellite communications company with bragging rights to the only network that offers voice and data connectivity anywhere in the world.   For over 20 years, Iridium’s unique network and services have supported critical communications needs for individuals, businesses, and the evolving Internet of Things.

At Iridium, we understand the importance of staying connected and the limitations of traditional communications networks. People across the globe, including first responders, humanitarians, global militaries, scientific researchers, and lone workers, as well as ships, aircraft and remote operations all rely on Iridium to stay connected. We take our responsibility for providing these essential communications very seriously and pride ourselves on offering a reliable lifeline when needed.  Likewise, Iridium is committed to providing an exciting and innovative workplace, where employees are challenged to think outside the box and collaborate on new, bold ideas and solutions.  Our talented teams are passionate about their work and the impact our company makes around the world.  Iridium fosters an empowering and inclusive culture that allows employees to genuinely be their best selves.   We are looking for others who want to join this truly unique company that celebrates our employees and provides the opportunity to truly make a difference in the world.


What We’re Looking For:

Iridium is seeking a talented, hands on Senior Program Finance Analyst to join our accounting team. You will be using your skills to compile, review, monitor and report on government programs. You will be heavily involved in ongoing reporting requirements and analysis for established programs. In this role you will work closely with program managers, contracts, and the business unit, as well as perform a variety of accounting related activites in connection to government programs.

What You’ll Do:
  • Work with project managers, contracts, accounting, and the business to lead project teams in the planning, tracking, analysis, and reporting of projects of varying contract types, size, and complexity.
  • Develop, maintain, and update program Estimates-at-Complete (EACs) and Estimates-to-Complete (ETCs) monthly to ensure proper cost accounting and revenue recognition per each contract.
  • Track Contract Value and Funded Value with percent complete analysis, including subcontractor / vendor obligations, funding limitation notices, and support PMO with other program related reporting. Prepare and support any Contract Data Requirements Lists (CDRLs).
  • Manage and own all financial inputs and submittals in support of the EVMS cycle by delivering actuals, maintaining Work Breakdown Structure (WBS), providing variance analysis, and submitting the Contract Funds Status Report (CFSR).
  • Lead corporate planning for annual budgeting and quarterly forecasting cycles with PMs and business partners. Ensure that all required finance inputs, including internal and external reporting, are prepared, reviewed, and submitted on time with documented assumptions.
  • Create financial charts in support of monthly program reviews that highlight funding status, unbilled analysis, aged receivables, utilization, and risks and opportunities. Identify cost impacts and develop recovery plans as required. Present financial results to PMO, management, and executive teams.
  • Support month-end close process, accrual preparation and review, and interpret variance/trend analyses for actuals compared to budget and forecast.
  • Program life-cycle activities such as project setup/maintenance, invoicing support, and contract closeout activities.
  • Support invoicing of CPFF/CR/FFP & TM contract types and develop any backup support for submission.
  • Implement improvements of financial policies and procedures in support of projects.
  • Support of government compliance and audit activities.

What You’ll Need to Succeed:
  • Good understanding of multiple contract types: CPAF, CPFF, CPIF, FFP, IDIQ, T&M.
  • Working knowledge of Federal Acquisition Regulations (FAR), Department of Defense FAR Supplement (DFAR), Cost Accounting Standards (CAS), and Generally Accepted Accounting Principles (GAAP).
  • Ability to identify risks, evaluate the probability and magnitude, and implement risk-mitigating strategies.
  • Hands-on experience in the development, maintenance, and/or tracking of Work Breakdown Structures (WBS’s) / Contract Line Item Numbers (CLINs). Understand how job costs are collected and billed on all contract types.
  • Accounting experience in support of government programs.
  • Strong MS Excel (e.g. Pivot Tables / Advanced formulas) and Office skills (e.g. PowerPoint).
  • Strong organization, analytical, communication, presentation, and interpersonal skills. Detail oriented, with a strong attention to detail and accuracy.
  • Be active in seeking out ways to improve yourself and gain new knowledge and be enthusiastic in sharing knowledge with others.
  • Take initiative and identify ways to add value through innovative solutions.
Things That Would be Great if You Brought to the Table:
  • Bachelor’s Degree in Accounting, Finance, or related field
  • [6-8+] years of relevant experience in government contracting
  • US citizenship required and lawful permanent resident of the U.S.

Work Environment:

This position primarily works in an office setting and is largely sedentary with the majority of the position working with a computer. The role typically requires the use of basic office equipment such as a phone, video, computer, keyboard, mouse, and printer. 

We believe in-person connection drives innovation, strengthens mentorship, and builds culture, while flexibility enables employees to do their best work. Under Iridium’s Hybrid Work Policy, employees are expected to work at least three days per week (approximately 60%) in an Iridium office to support collaboration, relationship-building, and professional growth.

 

Additional Information

This job description outlines the general nature and level of work for this role and is not a comprehensive list of duties, responsibilities, or qualifications. Employees may be assigned additional responsibilities as needed.

Base Pay Range: $105,000 - $140,000 USD

Actual compensation will be determined based on a variety of factors and this range represents an estimate of compensation at the time of posting. Base salary is only one part of our compensation package for this role. You may also be eligible for company stock and annual bonus. Employee benefits also include medical, dental, and vision insurance coverage; 401(k) retirement plan options; paid time off and paid holidays; paid parental leave; and other discounts and perks.

Iridium is an Equal Opportunity Employer, including individuals with disabilities and protected veterans.