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Remote Utilization Management Jobs in Virginia (NOW HIRING)

CrewBloom

Licensed Practical Nurse (US)

Alexandria, VA · Remote

$27.50 - $37.25/hr

Proactively manage patient health by monitoring remote patient monitoring (RPM) dashboards and ... A deep commitment to preventive care and reducing hospital readmissions/ER utilization. * Ability ...

CrewBloom

Licensed Practical Nurse (US)

Roanoke, VA · Remote

$25.25 - $34.25/hr

Proactively manage patient health by monitoring remote patient monitoring (RPM) dashboards and ... A deep commitment to preventive care and reducing hospital readmissions/ER utilization. * Ability ...

CrewBloom

Licensed Practical Nurse (US)

Newport News, VA · Remote

$23.50 - $31.75/hr

Proactively manage patient health by monitoring remote patient monitoring (RPM) dashboards and ... A deep commitment to preventive care and reducing hospital readmissions/ER utilization. * Ability ...

Sentara Healthcare

Nurse Case Manager

Richmond, VA · On-site +1

Position is remote but does require in person face-to-face assessments multiple times throughout ... efficient utilization of health benefits; conducts gap in care management for quality programs

Sentara Healthcare

Nurse Case Manager

Newport News, VA · On-site +1

Position is remote but does require in person face-to-face assessments multiple times throughout ... efficient utilization of health benefits; conducts gap in care management for quality programs

Sentara Healthcare

Nurse Case Manager

Newport News, VA · On-site +1

Position is remote but does require in person face-to-face assessments multiple times throughout ... efficient utilization of health benefits; conducts gap in care management for quality programs

Cleo

Customer Success Manager

Richmond, VA · Remote

Customer Success Manager Remote - US What You Will Be Doing * Manage a portfolio of 30+ accounts ... Monitor and act on customer health indicators, including utilization scores, CSM scores, support ...

Akima

IT Analyst II with Security Clearance

Ashburn, VA · Remote

$85K - $95K/yr

Akima Data Management is looking for a Records Information Management Analyst join our team ... Perform digitization of physical records and utilization of proper metadata * Tracks records ...

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Remote Utilization Management information

See Virginia salary details

$21

$41

$68

How much do remote utilization management jobs pay per hour?

As of Jun 9, 2026, the average hourly pay for remote utilization management in Virginia is $41.92, according to ZipRecruiter salary data. Most workers in this role earn between $33.12 and $48.12 per hour, depending on experience, location, and employer.

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 are the key skills and qualifications needed to thrive as a Remote Utilization Management Nurse, and why are they important?

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.

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 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 June 2026, with employment types broken down into 2% Internship, 91% Full Time, and 7% Part Time. Highlights an 100% Remote job distribution, with an average salary of $87,192 per year, or $41.9 per hour.
Integrated Case Manager- Registered Nurse

Integrated Case Manager- Registered Nurse

Sentara

Virginia Beach, VA • Remote

$10K/mo

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 8 days ago

Sentara Health rating

6.8

Company rating: 6.8 out of 10

Based on 383 frontline employees who took The Breakroom Quiz

484th of 870 rated healthcare providers

Job description

City/State

Virginia Beach, VA

Work Shift

First (Days)

Overview:

Sentara Health is looking to hire an Integrated Case Manager, RN.

This is a remote position; however, candidates must reside in Virginia Beach and Eastern Shore areas as travel is required.

The Integrated Case Manager is responsible for case management services within the scope of licensure; develops, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of optimizing member health care across the care continuum. Performs telephonic or face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical and behavioral health, social services and long-term services.

Identifies members for high-risk complications and coordinates care in conjunction with the member and health care team. Manages chronic illnesses, co-morbidities, and/or disabilities ensuring cost effective and efficient utilization of health benefits; conducts gap in care management for quality programs. Assists with the implementation of member care plans by facilitating authorizations/referrals within benefits structure or extra-contractual arrangements, as permissible. Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on care management treatment plans. Presents cases at case conferences for multidisciplinary focus. Ensure compliance with regulatory, accrediting and company policies and procedures. May assist in problem solving with provider, claims or service issues.

Demonstrates the minimum knowledge, skills and abilities to care for the individualized needs of the patient to include physical, psychological, socio-cultural, spiritual and cognitive needs as well as functional abilities including the need for diversified use of such practices. Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills

Education:

  • Associates
  • Bachelors preferred

Certification:

  • Registered Nurse required

Experience:

  • 3 years of nursing experience required
  • Managed care preferred
  • Discharge planning experience preferred

Keywords: Talroo- Health, Case Management, Managed Care, Discharge Planning

Benefits: Caring For Your Family and Your Career
Medical, Dental, Vision plans
Adoption, Fertility and Surrogacy Reimbursement up to $10,000
Paid Time Off and Sick Leave
Paid Parental & Family Caregiver Leave
Emergency Backup Care
Long-Term, Short-Term Disability, and Critical Illness plans
Life Insurance
401k/403B with Employer Match
Tuition Assistance - $5,250/year and discounted educational opportunities through Guild Education
Student Debt Pay Down - $10,000
Reimbursement for certifications and free access to complete CEUs and professional development
Pet Insurance
Legal Resources Plan
Colleagues have the opportunity to earn an annual discretionary bonus ifestablished system and employee eligibility criteria is met.

Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.


In support of our mission "to improve health every day," this is a tobacco-free environment.

For positions that are available as remote work, Sentara Health employs associates in the following states:

Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

What Sentara Health employees say

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