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Remote Utilization Management Jobs in Virginia (NOW HIRING)

Prestige

LPN Case Manager

Richmond, VA · Remote

$75K/yr

Monitor length of stay and levels of care to ensure appropriate resource utilization * Maintain ... This is a Remote Position. * Competitive Salary * Medical, Dental, and Vision Insurance * 401K ...

Siemens Healthineers

... maximum utilization of company products and training by customers to meet their business needs ... RTT or CMD with a history of at least 6 years of direct patient care experience, Management and ...

Cushman & Wakefield

Occupancy Planner

Arlington, VA · On-site +1

East Coast remote eligible for the right candidate. Key Responsibilities * Manage and own a ... Monitor space utilization against approved plans, workplace standards, and occupancy targets.

Cushman & Wakefield

Occupancy Planner

Arlington, VA · On-site +1

East Coast remote eligible for the right candidate. Key Responsibilities * Manage and own a ... Monitor space utilization against approved plans, workplace standards, and occupancy targets.

Cushman & Wakefield

Occupancy Planner

Arlington, VA · On-site +1

East Coast remote eligible for the right candidate. Key Responsibilities * Manage and own a ... Monitor space utilization against approved plans, workplace standards, and occupancy targets.

Cushman & Wakefield

Occupancy Planner

Arlington, VA · On-site +1

East Coast remote eligible for the right candidate. Key Responsibilities * Manage and own a ... Monitor space utilization against approved plans, workplace standards, and occupancy targets.

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Remote Utilization Management information

What is remote utilization management?

Remote utilization management is a process in which healthcare professionals, such as nurses or case managers, review and assess the necessity, efficiency, and appropriateness of medical services—often from a remote location. These professionals typically work for insurance companies, hospitals, or healthcare organizations to ensure that patients receive the right care while controlling costs. By working remotely, they use electronic health records, phone calls, and other digital tools to collaborate with providers and patients. This role helps improve healthcare quality and cost-effectiveness while allowing employees flexible work arrangements.

What are the key skills and qualifications needed to thrive in remote utilization management?

Success as a Remote Utilization Management Nurse requires a registered nursing license, clinical experience, and strong knowledge of medical necessity criteria and insurance guidelines. Familiarity with utilization review software, electronic health records (EHRs), and case management systems is typically necessary. Exceptional communication, critical thinking, and organizational skills help professionals excel in evaluating cases and coordinating with providers remotely. These skills are crucial for ensuring appropriate care, cost-effective resource use, and regulatory compliance in a remote healthcare setting.

How does a remote utilization management professional typically collaborate with healthcare providers and insurance teams?

Remote Utilization Management professionals frequently interact with both healthcare providers and insurance teams through secure digital platforms, phone calls, and virtual meetings. They review patient records, assess the necessity of medical services, and communicate their recommendations or authorization decisions. Effective collaboration requires clear documentation, timely responses, and strong communication skills to ensure that care is both medically appropriate and cost-effective. While the work is often independent, regular coordination with interdisciplinary teams is essential for maintaining high-quality patient outcomes and adhering to regulatory standards.

What is the difference between Remote Utilization Management vs Remote Case Management?

AspectRemote Utilization ManagementRemote Case Management
CredentialsRN, LPN, or licensed healthcare professionalsRN, LPN, or social workers
Work EnvironmentHealthcare facilities, insurance companies, telehealthHealthcare providers, insurance, community agencies
Industry UsageInsurance, healthcare, telehealthHealthcare, social services, insurance
Primary FocusReviewing medical necessity, authorizationsCoordinating patient care, support services

Remote Utilization Management primarily involves reviewing medical necessity and authorizations, while Remote Case Management focuses on coordinating patient care and support services. Both roles require healthcare credentials and are used within healthcare and insurance industries, but they serve different functions in patient care and resource allocation.

What are the most commonly searched types of Utilization Management jobs in Virginia?

The most popular types of Utilization Management jobs in Virginia are:

What are popular job titles related to Remote Utilization Management jobs in Virginia?

For Remote Utilization Management jobs in Virginia, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Management jobs in Virginia look for?

The top searched job categories for Remote Utilization Management jobs in Virginia are:

What cities in Virginia are hiring for Remote Utilization Management jobs?

Cities in Virginia with the most Remote Utilization Management job openings:

Remote Utilization Management jobs near you
Infographic showing various Remote Utilization Management job openings in Virginia as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution.

LPN Case Manager

Prestige

Richmond, VA • Remote

$75K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 8 days ago

Job description

Case Manager

At Prestige Healthcare Services, we are committed to delivering exceptional care and support to our patients and their families. Our skilled facilities offer a range of short-term and long-term skilled rehabilitation services to meet the diverse needs of our patients. We are seeking a dedicated and compassionate Case Manager to join our team.

Responsibilities:

• Develop, implement, and monitor individualized care plans in collaboration with the interdisciplinary team (nursing, therapy, social services, dietary)

• Coordinate and communicate with insurance companies and managed care organizations to obtain authorizations and manage utilization review

• Facilitate timely and safe discharge planning

• Serve as primary point of contact for residents and families regarding care plans, insurance coverage, and discharge options

• Monitor length of stay and levels of care to ensure appropriate resource utilization

• Maintain accurate and timely documentation in the electronic health record (EHR) in compliance with state and federal regulations

• Ensure compliance with CMS, state survey, and facility policies related to case management and discharge planning

• Collaborate with admissions to review referrals and support smooth transitions into the facility

What We Offer:

This is a Remote Position.

  • Competitive Salary

  • Medical, Dental, and Vision Insurance

  • 401K Retirement Plan

  • Paid Time Off (PTO) and Sick Time in accordance with VA Law

  • Employee Wellness Program

  • Flexible Spending Account

  • Employee Assistance Program

  • Daily Pay

Requirements

  • LPN in the state of Virginia

  • Experience in managed care/HMOS and skilled nursing admission and/or admissions coordination.

If you are a motivated and compassionate healthcare professional looking for a new challenge, we encourage you to apply for this exciting opportunity.

To learn more about this role and how you can make a difference at Prestige Healthcare Services, please apply today!

Prestige Healthcare Services is an equal opportunity employer.