A recognized healthcare provider is seeking a Board Certified Orthopaedic Spine Surgeon to conduct utilization reviews. This telework position allows for a flexible schedule within a standard Monday ...
A recognized healthcare provider is seeking a Board Certified Orthopaedic Spine Surgeon to conduct utilization reviews. This telework position allows for a flexible schedule within a standard Monday ...
A national provider of utilization review services seeks independent contract reviewers for a telework opportunity. Physicians can customize their caseload and schedule while providing advisory-only ...
A national provider of utilization review services seeks independent contract reviewers for a telework opportunity. Physicians can customize their caseload and schedule while providing advisory-only ...
A national Utilization Review provider is seeking Board Certified physicians with an active New York license for a telework opportunity. This role allows for flexible scheduling, where physicians can ...
A national Utilization Review provider is seeking Board Certified physicians with an active New York license for a telework opportunity. This role allows for flexible scheduling, where physicians can ...
Austin, TX; Remote This is a rare opportunity to step into a high-impact leadership role at the ... Utilization Review & Authorizations * Oversee authorization strategy and utilization review ...
Austin, TX; Remote This is a rare opportunity to step into a high-impact leadership role at the ... Utilization Review & Authorizations * Oversee authorization strategy and utilization review ...
PRN Clinical Reviewer - Substance Use (LPCC, LMFT, LICSW)
Mclean, VA · Remote
$28.37 - $39.19/hr
Job Summary Clinical Reviewer - Substance Use - LPCC, LMFT, LICSW - PRN (Remote U.S.) Responsible ... Review (UR) or Utilization Management (UM) or Prior Authorization experience. In-depth ...
PRN Clinical Reviewer - Substance Use (LPCC, LMFT, LICSW)
Mclean, VA · Remote
$28.37 - $39.19/hr
Job Summary Clinical Reviewer - Substance Use - LPCC, LMFT, LICSW - PRN (Remote U.S.) Responsible ... Review (UR) or Utilization Management (UM) or Prior Authorization experience. In-depth ...
Clinical, Supervisor
Mclean, VA · Remote
This position is remote U.S.*** ***Working hours between 8:00 a.m. and 6:00 p.m. EST, with ... Conduct utilization reviews as needed to support workload demands and program requirements.
New
Clinical, Supervisor
Mclean, VA · Remote
This position is remote U.S.*** ***Working hours between 8:00 a.m. and 6:00 p.m. EST, with ... Conduct utilization reviews as needed to support workload demands and program requirements.
New
Quality Analyst (Remote, LPN Required)
Washington, DC · Remote
$45K - $70K/yr
The Utilization Management Nurse Reviewer plays a crucial role in healthcare systems by ensuring ... Apple equipment and a media stipend are provided for remote workspace. About Dane Street: A fast ...
Quality Analyst (Remote, LPN Required)
Washington, DC · Remote
$45K - $70K/yr
The Utilization Management Nurse Reviewer plays a crucial role in healthcare systems by ensuring ... Apple equipment and a media stipend are provided for remote workspace. About Dane Street: A fast ...
The role is PRN (as needed) and remote within the United States but requires a Minnesota license ... Utilization Review (UR) OR Utilization Management (UM) OR Prior Authorization. * In-depth ...
The role is PRN (as needed) and remote within the United States but requires a Minnesota license ... Utilization Review (UR) OR Utilization Management (UM) OR Prior Authorization. * In-depth ...
HSS Manager - Remote in State of VA
Arlington, VA · On-site +1
$91.70K - $163.70K/yr
While Role is Remote, for consideration candidate MUST reside within the state of VA. Candidates ... Experience in utilization review, concurrent review and/or risk management *All employees working ...
HSS Manager - Remote in State of VA
Arlington, VA · On-site +1
$91.70K - $163.70K/yr
While Role is Remote, for consideration candidate MUST reside within the state of VA. Candidates ... Experience in utilization review, concurrent review and/or risk management *All employees working ...
HSS Manager - Remote in State of VA
Arlington, VA · Remote
$91.70K - $163.70K/yr
While Role is Remote, for consideration candidate MUST reside within the state of VA. Candidates ... Experience in utilization review, concurrent review and/or risk management *All employees working ...
HSS Manager - Remote in State of VA
Arlington, VA · Remote
$91.70K - $163.70K/yr
While Role is Remote, for consideration candidate MUST reside within the state of VA. Candidates ... Experience in utilization review, concurrent review and/or risk management *All employees working ...
Remote Prior Authorization Pharmacist
Silver Spring, MD · Remote
$60 - $72.25/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Remote Prior Authorization Pharmacist
Silver Spring, MD · Remote
$60 - $72.25/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Remote Prior Authorization Pharmacist
Ashburn, VA · Remote
$59.50 - $71.50/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Remote Prior Authorization Pharmacist
Ashburn, VA · Remote
$59.50 - $71.50/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Remote Prior Authorization Pharmacist
Annandale, VA · Remote
$58 - $69.50/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Remote Prior Authorization Pharmacist
Annandale, VA · Remote
$58 - $69.50/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Board Certified Behavior Analyst
Mclean, VA · Remote
$75.90K - $92.80K/yr
... Utilization Review or Prior Authorization. * Strong clinical assessment and critical thinking skills. * Proficiency in medical necessity review. * Ability to work independently in a remote ...
Board Certified Behavior Analyst
Mclean, VA · Remote
$75.90K - $92.80K/yr
... Utilization Review or Prior Authorization. * Strong clinical assessment and critical thinking skills. * Proficiency in medical necessity review. * Ability to work independently in a remote ...
ABA Authorization Specialist (Remote position)
Silver Spring, MD · On-site +1
$26.45/hr
... • Review treatment plans to ensure alignment with payer requirements and requested units • ... utilization and flag overutilization or underutilization risks • Communicate authorization ...
ABA Authorization Specialist (Remote position)
Silver Spring, MD · On-site +1
$26.45/hr
... • Review treatment plans to ensure alignment with payer requirements and requested units • ... utilization and flag overutilization or underutilization risks • Communicate authorization ...
Head Start Project Manager - Remote
Reston, VA · On-site +1
Oversee project budgets and staffing utilization. * Review monthly financial reports and support ... Experience managing remote or distributed teams. * Excellent written and verbal communication ...
Head Start Project Manager - Remote
Reston, VA · On-site +1
Oversee project budgets and staffing utilization. * Review monthly financial reports and support ... Experience managing remote or distributed teams. * Excellent written and verbal communication ...
Appeals Pharmacist (Remote)
Ashburn, VA · On-site +1
$58.50 - $71.25/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
Appeals Pharmacist (Remote)
Ashburn, VA · On-site +1
$58.50 - $71.25/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
Appeals Pharmacist (Remote)
Annandale, VA · On-site +1
$57 - $69.50/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
Appeals Pharmacist (Remote)
Annandale, VA · On-site +1
$57 - $69.50/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
Appeals Pharmacist (Remote)
Silver Spring, MD · On-site +1
$59 - $72/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
Appeals Pharmacist (Remote)
Silver Spring, MD · On-site +1
$59 - $72/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
Case Manager, Registered Nurse
Washington, DC · Remote
$54.10K - $155.54K/yr
Position Summary This is a remote work from home role anywhere in the US with virtual training ... Utilization Review. * CCM and/or other URAC recognized accreditation preferred. * 1+ years ...
Case Manager, Registered Nurse
Washington, DC · Remote
$54.10K - $155.54K/yr
Position Summary This is a remote work from home role anywhere in the US with virtual training ... Utilization Review. * CCM and/or other URAC recognized accreditation preferred. * 1+ years ...
Remote Optum Utilization Review information
See Ashburn, VA salary details
$21.88 - $26.30
2% of jobs
$26.30 - $30.73
9% of jobs
$33.75 is the 25th percentile. Wages below this are outliers.
$30.73 - $35.15
21% of jobs
The median wage is $38.73 / hr.
$35.15 - $39.58
23% of jobs
$39.58 - $44
13% of jobs
$47.44 is the 75th percentile. Wages above this are outliers.
$44 - $48.43
10% of jobs
$48.43 - $52.85
8% of jobs
$52.85 - $57.28
5% of jobs
$57.28 - $61.70
5% of jobs
$61.70 - $66.12
2% of jobs
$66.12 - $70.55
2% of jobs
$21
$43
$70
How much do remote optum utilization review jobs pay per hour?
As of May 28, 2026, the average hourly pay for remote optum utilization review in Ashburn, VA is $43.24, according to ZipRecruiter salary data. Most workers in this role earn between $34.18 and $49.66 per hour, depending on experience, location, and employer.
What are the key skills and qualifications needed to thrive as a Remote Optum Utilization Review Nurse, and why are they important?
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.
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 position?
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 is the difference between Remote Optum Utilization Review vs Remote UnitedHealthcare Utilization Review?
| Aspect | Remote Optum Utilization Review | Remote UnitedHealthcare Utilization Review |
|---|---|---|
| Credentials | Licenses in relevant states, certifications like CCM or CRC often preferred | Licenses in relevant states, certifications like CCM or CRC often preferred |
| Work Environment | Remote, home-based with flexible hours | Remote, home-based with flexible hours |
| Employer & Industry | Optum, healthcare services and utilization management | UnitedHealthcare, 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.
What are the most commonly searched types of Optum Utilization Review jobs in Ashburn, VA? The most popular types of Optum Utilization Review jobs in Ashburn, VA are:
What are popular job titles related to Remote Optum Utilization Review jobs in Ashburn, VA? For Remote Optum Utilization Review jobs in Ashburn, VA, the most frequently searched job titles are:
- Utilization Management Coordinator
- Utilization Management Physician Reviewer
- Evening Physician Advisor Utilization Review
- No Experience Physician Reviewer
- Remote Utilization Review Social Worker
- Haven Detox
- Cvs Health Utilization Management
- Flexible Cvs Utilization Management Nurse
- Remote Utilization Management Nurse
- Utilization Management
What job categories do people searching Remote Optum Utilization Review jobs in Ashburn, VA look for? The top searched job categories for Remote Optum Utilization Review jobs in Ashburn, VA are:
- Chart Utilization Review
- Remote Anthem Utilization Review Nurse
- Remote Pre Veterinary Medicine
- Authorization Utilization Review
- Hospital Case Manager
- Volunteer Navihealth Utilization Review
- Remote Aetna Utilization Review
- Remote Dental Utilization Management
- Utilization Review Coordinator Prn
- Remote Dental Utilization Review
What cities near Ashburn, VA are hiring for Remote Optum Utilization Review jobs? Cities near Ashburn, VA with the most Remote Optum Utilization Review job openings:
Contractor
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Job description
A recognized healthcare provider is seeking a Board Certified Orthopaedic Spine Surgeon to conduct utilization reviews. This telework position allows for a flexible schedule within a standard Monday – Friday work week. Responsibilities include reviewing medical records, ensuring compliance with state regulations, and providing clear rationale for case decisions.
Preferred candidates should have a license in specific states. Compensation is based on a per-case basis as a 1099 independent contractor. #J-18808-Ljbffr
About Dane Street
Sourced by ZipRecruiter
Company size
51 - 200 Employees
Headquarters location
Boston, MA, US
Year founded
2008