2

Remote Utilization Review Nurse Jobs in Reston, VA

UM Technician

Washington, DC · On-site +1

$27.02 - $36.78/hr

For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet ... Compensation plans for physicians, licensed nurse reviewers, staff, and consultants who conduct ...

... variances, utilization, forecast changes, material issues, and risks. * Monitor cloud budgets ... for review and disposition. * Participate in Agile or program-management ceremonies, including ...

... variances, utilization, forecast changes, material issues, and risks. * Monitor cloud budgets ... for review and disposition. * Participate in Agile or program-management ceremonies, including ...

... variances, utilization, forecast changes, material issues, and risks. * Monitor cloud budgets ... for review and disposition. * Participate in Agile or program-management ceremonies, including ...

Showing results 41-60

Remote Utilization Review Nurse information

See Reston, VA salary details

$22

$43

$71

How much do remote utilization review nurse jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for remote utilization review nurse in Reston, VA is $43.99, according to ZipRecruiter salary data. Most workers in this role earn between $34.76 and $50.53 per hour, depending on experience, location, and employer.

What is a remote utilization review nurse?

A Remote Utilization Review Nurse is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services and treatments, typically from a remote location such as their home. They review patient medical records, apply clinical guidelines, and collaborate with providers and insurance companies to ensure patients receive appropriate care while managing healthcare costs. This role often involves making coverage determinations, conducting pre-authorizations, and participating in appeals processes. Remote Utilization Review Nurses play a critical role in improving patient outcomes and resource allocation within the healthcare system.

What does a remote utilization review nurse do?

As a remote utilization nurse, your duties are to work from home or a remote location to review patient medical records and prepare a range of paperwork for different types of actions a hospital or health care provider can take. Your responsibilities are to determine patient coverage, carry out denial of service authorizations, and negotiate different treatment options and hospital stay length for patients. You rely on your knowledge of treatment options and diseases to determine the level of appropriate care for a patient. Because you telecommute, you also need good technical skills.

What are the key skills and qualifications needed to thrive as a remote utilization review nurse?

To thrive as a Remote Utilization Review Nurse, you need a current RN license, clinical experience, and a solid understanding of medical necessity criteria and healthcare regulations. Familiarity with utilization management software, EHR systems, and certifications like CCM or URAC are highly valued. Strong analytical thinking, attention to detail, and effective communication skills enable success in evaluating clinical documentation and collaborating with providers remotely. These skills and qualifications are essential to ensure efficient, compliant care decisions that optimize patient outcomes and resource use.

How does a remote utilization review nurse collaborate with physicians and other healthcare team members while working remotely?

As a Remote Utilization Review Nurse, collaboration with physicians, case managers, and other healthcare professionals is primarily conducted through secure digital platforms such as email, video conferencing, and electronic health record systems. Effective communication is essential to discuss patient care plans, clarify medical necessity, and ensure compliance with utilization policies. Nurses in this role often participate in virtual meetings or case conferences to present findings and recommendations. Building strong working relationships remotely requires proactive communication, responsiveness, and familiarity with digital collaboration tools.

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

AspectRemote Utilization Review NurseRemote Case Manager
CertificationsRN license, possibly CCM or UR certificationsRN license, CCM or case management certifications
Work EnvironmentHealthcare facilities, insurance companies, telehealthInsurance companies, healthcare organizations, telehealth
Job FocusReview medical necessity, approve or deny servicesCoordinate patient care, arrange services, discharge planning

Remote Utilization Review Nurses primarily evaluate medical necessity for services, while Remote Case Managers coordinate patient care and discharge planning. Both roles require nursing credentials and work in healthcare or insurance settings, but their core responsibilities differ. Understanding these distinctions helps job seekers find the best fit for their skills and career goals.

What are popular job titles related to Remote Utilization Review Nurse jobs in Reston, VA?

For Remote Utilization Review Nurse jobs in Reston, VA, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Review Nurse jobs in Reston, VA look for?

The top searched job categories for Remote Utilization Review Nurse jobs in Reston, VA are:

What cities near Reston, VA are hiring for Remote Utilization Review Nurse jobs?

Cities near Reston, VA with the most Remote Utilization Review Nurse job openings:

Infographic showing various Remote Utilization Review Nurse job openings in Reston, VA as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 17% Part Time, 1% Temporary, and 3% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $91,496 per year, or $44 per hour.

Lead Researcher & SME - Forced Labor and Human Trafficking in Supply Chains

McColm and Company

Arlington, VA • Remote

$192K/yr

Contractor

Posted 26 days ago


Job description

Position: Lead Researcher and Subject Matter Expert (SME)

Engagement Type: Short Term Consultancy

Location: Fully Remote

Deadline: Rolling, position is open until filled

McColm & Company (McColm) is a mission-driven and customer-focused professional services firm that equips change makers with the knowledge, skills, and insights they need to succeed in an increasingly complex world. McColm specializes in supporting U.S. federal customers with national security, human services, foreign affairs, and emergency response-focused portfolios by managing bespoke professional training programs, delivering effective capacity building solutions, and providing highly specialized technical assistance and analysis expertise to decision makers.

McColm's Justice and Resilience Practice supports U.S. Government clients working to identify and mitigate forced labor and human trafficking risks globally. McColm seeks a subject matter expert to serve as the Lead Researcher and Subject Matter Expert (SME) for a Strategic Assessment and Gap Analysis project related to force labor and human trafficking in global supply chains.

The Lead Researcher will serve as the methodological lead for this project and is the principal author of study. The project combines structured stakeholder interviews and focus groups, stakeholder surveys, document and policy review, analysis of utilization data, and comparative benchmarking. Findings are triangulated across data sources to characterize operational, technical, policy, content, and capability gaps, and to inform prioritized, evidence-based recommendations on future-state operating, governance, and funding models.

The position is fully remote and requires virtual meetings and briefings with government personnel and stakeholders. The Lead Researcher coordinates closely with the U.S. Government client, a Senior Project Director, a supporting Investigator/SME, and lived experience expert reviewers.

This position is classed as a 1099 Independent Contractor.

Duties

The responsibilities of the Lead Researcher and SME include, but are not necessarily limited to, the following duties:

  • Serve as lead researcher and methodological lead for the assessment, drafting the methodology and tool development, including stakeholder mapping, sampling strategy, interview and focus group protocols, survey instruments, and the analytic framework.
  • Design and lead all data collection activities, including structured stakeholder interviews and focus groups, stakeholder surveys, document and policy review, and analysis of utilization data.
  • Lead comparative benchmarking analysis.
  • Triangulate qualitative and quantitative findings across data sources; identify operational, technical, policy, content, and capability gaps; and characterize evidence limitations and confidence levels with methodological transparency.
  • Draft substantive sections of the Draft and Final Strategic Assessment and Gap Analysis Reports, including current-state, governance, and sustainability assessments; utilization and comparative value findings; benchmarking observations; gap, risk, and maturity analysis; and future-state operating, governance, and funding options.
  • Coordinate closely with the Senior Project Director, a supporting Investigator/SME, and network consultant reviewers, and participate in periodic virtual meetings with government personnel and stakeholders.

Requirements

  • Advanced degree (Master's or higher preferred) in public policy, international relations, human rights, law, economics, social science research, or a related field, or equivalent professional experience.
  • Demonstrated subject matter expertise in responsible sourcing, supply chain due diligence, forced labor risk mitigation, and/or anti-trafficking policy, including familiarity with federal anti-trafficking procurement requirements.
  • Proven experience leading mixed-methods research or evaluations, including design of sampling strategies, interview and focus group protocols, and survey instruments, and triangulation of qualitative and quantitative data.
  • Experience conducting program assessments, evaluations, gap analyses, or strategic reviews for U.S. Government clients or comparable institutional clients.
  • Prior experience supporting U.S. Government clients through research.
  • Strong analytical writing skills, with demonstrated ability to produce evidence-based reports and actionable recommendations for senior government decision-makers.
  • Excellent stakeholder engagement and facilitation skills, including experience interviewing government, private sector, and lived experience stakeholders.
  • Experience applying trauma-informed and survivor-centered approaches in the overall research approach and when engaging with lived experience expert reviewers and stakeholders.
  • Experience with benchmarking or comparative analysis of digital tools or platforms, including governance, sustainability, and funding model assessment.
  • Strong experience using AI tools for data analysis.
  • Ability to work independently in a remote environment and manage competing deadlines across a phased workplan.

Benefits

Compensation is offered according to job requirements, market dynamics, and experience/skills of the successful candidate. Contract and consultant roles are not eligible for benefits.

We are an equal opportunity employer offering employment without regard to race, color, religion, sex, age, sexual orientation, national origin, citizenship, gender identity or expression, disability status, or any other characteristic protected by federal, state or local laws.

Due to the high volume of applications McColm receives and to ensure we comply with our internal hiring policies, we regret we are not able to respond to individual phone calls or emails regarding submission status.