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Remote Utilization Review Manager Jobs in Virginia

Elevance Health

Med Mgmt Nurse (contract)

Richmond, VA · Remote

... utilization review, or managed care experience; or any combination of education and experience ... No weekends, holidays or overtime * 100% Remote (50 miles or 1 hour commute from a Pulse Point ...

Elevance Health

Med Mgmt Nurse (contract)

Richmond, VA · Remote

... utilization review, or managed care experience; or any combination of education and experience ... No weekends, holidays or overtime * 100% Remote (50 miles or 1 hour commute from a Pulse Point ...

MillerMusmar CPAs

Tax Program Manager

Reston, VA · On-site +1

$115K - $151K/yr

Role Summary We are seeking a full-time Tax Manager with strong experience in 1040 review, tax ... review conversations and client interactions Comfortable working in a hybrid or remote team ...

AO Globe Life

Remote- Entry Level Manager

Richmond, VA · On-site +1

The Opportunity As a Remote Sales Manager, you'll lead a team of dedicated professionals while ... Oversee customer accounts, verify coverage eligibility, and review healthcare options. * Process ...

AO Globe Life

Remote- Entry Level Manager

Richmond, VA · On-site +1

The Opportunity As a Remote Sales Manager, you'll lead a team of dedicated professionals while ... Oversee customer accounts, verify coverage eligibility, and review healthcare options. * Process ...

AO Globe Life

Remote- Entry Level Manager

Richmond, VA · On-site +1

The Opportunity As a Remote Sales Manager, you'll lead a team of dedicated professionals while ... Oversee customer accounts, verify coverage eligibility, and review healthcare options. * Process ...

AO Globe Life

Remote- Entry Level Manager

Richmond, VA · On-site +1

The Opportunity As a Remote Sales Manager, you'll lead a team of dedicated professionals while ... Oversee customer accounts, verify coverage eligibility, and review healthcare options. * Process ...

AO Globe Life

Remote- Entry Level Manager

Arlington, VA · On-site +1

The Opportunity As a Remote Sales Manager, you'll lead a team of dedicated professionals while ... Oversee customer accounts, verify coverage eligibility, and review healthcare options. * Process ...

AO Globe Life

Remote- Entry Level Manager

Arlington, VA · On-site +1

The Opportunity As a Remote Sales Manager, you'll lead a team of dedicated professionals while ... Oversee customer accounts, verify coverage eligibility, and review healthcare options. * Process ...

AO Globe Life

Remote- Entry Level Manager

Richmond, VA · On-site +1

The Opportunity As a Remote Sales Manager, you'll lead a team of dedicated professionals while ... Oversee customer accounts, verify coverage eligibility, and review healthcare options. * Process ...

AO Globe Life

Remote- Entry Level Manager

Arlington, VA · On-site +1

The Opportunity As a Remote Sales Manager, you'll lead a team of dedicated professionals while ... Oversee customer accounts, verify coverage eligibility, and review healthcare options. * Process ...

AO Globe Life

Remote- Entry Level Manager

Arlington, VA · On-site +1

The Opportunity As a Remote Sales Manager, you'll lead a team of dedicated professionals while ... Oversee customer accounts, verify coverage eligibility, and review healthcare options. * Process ...

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All JobsUtilization Review JobsRemote Utilization Review Manager JobsRemote Utilization Review Manager Jobs in Virginia

Remote Utilization Review Manager information

What are some common challenges faced by a Remote Utilization Review Manager, and how can they be addressed?

A Remote Utilization Review Manager often encounters challenges such as maintaining effective communication with clinical teams, ensuring timely and accurate reviews, and staying updated with changing regulations and payer requirements. To address these, it's important to leverage secure collaborative platforms, establish clear workflows, and participate in ongoing training. Building strong relationships with team members and regularly reviewing protocols also help in overcoming remote work hurdles and ensuring compliance and efficiency.

What is the difference between Remote Utilization Review Manager vs Remote Utilization Review Nurse?

AspectRemote Utilization Review ManagerRemote Utilization Review Nurse
CredentialsTypically requires a nursing license, certifications like URAC or AAPC, and management experienceLicensed Registered Nurse (RN) with utilization review certification often preferred
Work EnvironmentOversees review teams, manages processes, and ensures compliance remotelyPerforms case reviews, assesses medical necessity, and documents findings remotely
Employer & Industry UsageHealth insurance companies, third-party administrators, healthcare organizations

The Remote Utilization Review Manager focuses on overseeing review teams and managing processes, while the Remote Utilization Review Nurse conducts case assessments and medical necessity reviews. Both roles require nursing credentials and are integral to healthcare utilization management, but differ in responsibilities and leadership levels.

What is a Remote Utilization Review Manager?

A Remote Utilization Review Manager is a healthcare professional responsible for overseeing the review of medical services and determining the necessity, appropriateness, and efficiency of those services from a remote location. They ensure that healthcare providers comply with guidelines and that patients receive appropriate care without unnecessary procedures. These managers work with clinical teams, insurance companies, and regulatory agencies to optimize patient outcomes and manage healthcare costs. Working remotely allows them to perform these duties using digital health records and telecommunication tools.

What are the key skills and qualifications needed to thrive as a Remote Utilization Review Manager, and why are they important?

To thrive as a Remote Utilization Review Manager, you need expertise in healthcare management, case review, and regulatory compliance, typically supported by a nursing degree (RN or BSN) and relevant certifications such as CCM or URAC. Familiarity with utilization management software, electronic health records (EHRs), and payer systems is essential. Strong analytical thinking, attention to detail, and excellent communication skills help navigate complex cases and collaborate with clinical teams and insurers. These skills ensure effective resource utilization, regulatory adherence, and optimal patient outcomes in a remote healthcare environment.
What are the most commonly searched types of Remote Utilization Review jobs in Virginia? The most popular types of Remote Utilization Review jobs in Virginia are:
What are popular job titles related to Remote Utilization Review Manager jobs in Virginia? For Remote Utilization Review Manager jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Manager jobs in Virginia look for? The top searched job categories for Remote Utilization Review Manager jobs in Virginia are:
What cities in Virginia are hiring for Remote Utilization Review Manager jobs? Cities in Virginia with the most Remote Utilization Review Manager job openings:
Remote Utilization Review Manager jobs near you
Contract Mandarin Document Review Attorney

Contract Mandarin Document Review Attorney

Contact Government Services, LLC

Fairfax, VA • On-site, Remote

$60/hr

Full-time

Posted 16 days ago

Job description

Mandarin Document Reviewer
Contact Review - Washington, DC
Location: Remote
Start Date: Negotiable
 
EXPERIENCE & QUALIFICATIONS:
Familiarity with document review workflows 
Examples: Privilege/Responsiveness Review, Redactions, Conceptual Searching, First and Second Review, etc.
Experience with electronic document review technology
Examples: Relativity, Concordance, ViewPoint, etc.
Active bar admission in at least 1 U.S. Jurisdiction and status in good standing
Ability to read/write Mandarin Chinese.
THE FOLLOWING SKILLS ARE PREFERRED BUT NOT REQUIRED:
Experience as a member of a document review team
Familiarity with Relativity 9.0 or higher version
2+ years of legal support experience
HOURS & LOCATION
Location (including opportunity for remote work) is established on a project-by-project basis
Hours (including the opportunity to work outside standard business hours) are established on a project-by-project basis
 
About Contact:
Contact Review prides itself on finding high-quality, high-accountability, barred attorneys specifically tailored to the needs of our project. We seek attorneys to assist with document review, privilege review, expert testimony, legal research, and foreign language translation. Unlike other eDiscovery vendors, Contact fosters a culture where every project manager, programmer, engineer, reviewer, and analyst sees themselves as an extension of the projects' team. Here at Contact, we look for ways to improve efficiency, streamline workflows, and put our clients in the best possible position to weather the next storm. 
For more information about Contact Review please visit: https://contactdiscoveryservices.com/managed-document-review/
 #CJ
$60 - $60 an hour
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
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