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Remote Utilization Review Rn Jobs in Virginia (NOW HIRING)

RN Field Case Manager

Fredericksburg, VA · Remote

$76K - $97K/yr

Must have an RN and prefers 1.5 years of prior workers compensation experience. PRIMARY PURPOSE OF ... remote work environment that allows face to face interaction with injured workers and medical ...

RN Field Case Manager

Fairfax, VA · Remote

$79K - $101K/yr

... remote work environment that allows face to face interaction with injured workers and medical ... RN licensure required. Valid driver's license required. High speed internet required. Employment ...

RN Field Case Manager

Fredericksburg, VA · Remote

$76K - $97K/yr

Must have an RN and prefers 1.5 years of prior workers compensation experience. PRIMARY PURPOSE OF ... remote work environment that allows face to face interaction with injured workers and medical ...

RN Field Case Manager

Fairfax, VA · Remote

$79K - $101K/yr

... remote work environment that allows face to face interaction with injured workers and medical ... RN licensure required. Valid driver's license required. High speed internet required. Employment ...

Licensed Practical Nurse (US)

Alexandria, VA · Remote

$27.50 - $37.50/hr

We're looking for a Licensed Practical Nurse (LPN) focused on remote patient monitoring and ... A deep commitment to preventive care and reducing hospital readmissions/ER utilization. * Ability ...

Care Facilitator/LPN

Richmond, VA · Remote

$25.50 - $34.75/hr

At Home Harmony's Clinical Team is comprised of experienced RNs, LPNs, and Medical Assistants who ... Prepare, review, and upload all pre-visit documentation into the EMR (Athena) * Review hospital ...

Along with excellent benefits, McGuireWoods offers most employees a hybrid remote option allowing ... Lead the annual benefits renewal process, including plan design evaluation, utilization review ...

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Showing results 1-20

Remote Utilization Review Rn information

See Virginia salary details

$21

$41

$68

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

As of Jul 24, 2026, the average hourly pay for remote utilization review rn 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.

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

To excel as a Remote Utilization Review RN, you need a valid RN license, strong clinical judgment, and knowledge of utilization management principles. Familiarity with electronic medical records (EMR), utilization management software, and guidelines such as InterQual or MCG is typically required. Outstanding attention to detail, critical thinking, and effective communication skills help you collaborate with healthcare teams and advocate for appropriate patient care. These competencies are crucial for ensuring medical necessity, regulatory compliance, and optimal resource use in a remote setting.

What is a Remote Utilization Review RN?

A Remote Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services provided to patients, typically working from a remote location. They review medical records, apply clinical guidelines, and collaborate with healthcare providers to ensure patients receive the right care at the right time. Their work helps manage healthcare costs and improves patient outcomes by preventing unnecessary treatments or hospital stays. Remote Utilization Review RNs often work for insurance companies, hospitals, or healthcare organizations, and use secure digital platforms to conduct their reviews.

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

AspectRemote Utilization Review RnRemote Case Manager Rn
CertificationsRN license, Utilization Review certification (e.g., URAC)RN license, Case Management certification (e.g., CCM)
Work EnvironmentReviewing medical records, insurance policies, telehealth platformsCoordinating patient care, discharge planning, telehealth
Employer & IndustryInsurance companies, healthcare organizationsHospitals, insurance providers, healthcare agencies

Remote Utilization Review Rns primarily focus on evaluating medical necessity for insurance coverage, while Remote Case Manager Rns coordinate patient care and discharge planning. Both roles require RN licensure and involve telehealth work, but they serve different functions within healthcare and insurance industries.

What are some common challenges Remote Utilization Review RNs face when working from home, and how can they be addressed?

Remote Utilization Review RNs often encounter challenges such as maintaining clear communication with interdisciplinary teams, managing time efficiently, and staying updated on changing payer guidelines. To address these challenges, it's important to establish consistent check-ins with team members via video or chat platforms, use digital tools to organize and prioritize caseloads, and participate in ongoing training sessions provided by employers. Adhering to a structured daily routine and leveraging available technology can help ensure productivity and high-quality reviews while working remotely.
What cities in Virginia are hiring for Remote Utilization Review Rn jobs? Cities in Virginia with the most Remote Utilization Review Rn job openings:
Infographic showing various Remote Utilization Review Rn job openings in Virginia as of July 2026, with employment types broken down into 72% Full Time, 10% Part Time, 2% Temporary, and 16% Contract. Highlights an 43% Physical, 3% Hybrid, and 54% Remote job distribution, with an average salary of $87,192 per year, or $41.9 per hour.
Bilingual Health Specialist (RN, Temporary, Remote)

Bilingual Health Specialist (RN, Temporary, Remote)

Maximus

VA • On-site, Remote

$17 - $22/hr

Full-time

Posted 8 days ago


Maximus rating

6.9

Company rating: 6.9 out of 10

Based on 297 frontline employees who took The Breakroom Quiz

259th of 454 rated business services


Job description

General information
Job Posting Title
Bilingual Health Specialist (RN, Temporary, Remote)
Date
Thursday, July 16, 2026
City
Remote
Country
United States
Working time
Full-time
Description & Requirements
Maximus is currently hiring for a Bilingual Health Specialist to support our CDC INFO (Centers for Disease Control) Call Center. The Health Specialist's role is to provide advanced and accurate clinical inquiry responses to health related, disease control and prevention issues, including questions related to bioterrorism, first responders and national emergency situations from medical and other health care professionals, educators, and government agencies.
- This is a temporary position, projected to last through August 31st, 2026.
- This position requires an active, valid RN license.
- This position requires a two-week training schedule of 8:00am - 4:30pm EST Monday - Friday with zero absences.
- After training concludes, the work schedule assigned is 11:30am - 8:00pm EST Monday - Friday.
- Extended hours (weekend and/or holiday) may be required on occasion, depending on business needs.
- This position requires the use of your own computer equipment (See detailed requirements below).
Essential Duties and Responsibilities:
- Provides advanced clinical inquiry responses (verbal and written) to health-related inquiries from consumers, educators or medical/health professionals.
- Provides medical subject matter expertise.
- Performs advanced database searches.
- Composes documents, reports, and correspondence.
- Documents all incoming inquiries.
- Participates in special projects as required.
- Provide advanced clinical inquiry responses (verbal and written) to health related inquiries from consumers, educators and medical/health professionals including State and local health departments and other government offices.
- Provide subject matter expertise on CDC topics covered by CDC-INFO which includes HIV/AIDS, Immunizations, Environmental Health, NIOSH; Tuberculosis and Statistics, to name a few.
- Respond to inquiries resulting from current events, such as food outbreaks, natural disasters and other events.
- Perform advanced database searches.
- Perform assigned work in accordance with quality assurance measures.
- Respond to medical personnel and clinicians in both verbal and written formats.
Minimum Requirements
- High School diploma or equivalent with 2-4 years of experience.
- May have additional training or education in area of specialization.
- Must be fluent in English and specified secondary language.
- Bachelor's Degree in Nursing and current RN license is required.
- Experience in medical, scientific and public health discipline.
- Clinical knowledge of and experienced in CDC related topics.
- Proficient internet search skills.
- Working knowledge of Microsoft Office and ability to learn and utilize software applications.
- Excellent listening, comprehension, communications (verbal and written), problem solving and customer service skills.
- Ability to work independently and communicate effectively.
- Must have demonstrated excellent interpersonal and leadership skills and the ability to organize simultaneous tasks.
- Ability to speak and read English and Spanish clearly, professionally, and fluently.
- Ability to commit to a two-week training schedule of 8:00am - 4:30pm EST Monday - Friday with zero absences.
- Ability to commit to a work schedule of 11:30am - 8:00pm EST Monday - Friday after training concludes.
- Ability to work weekends and holidays as business needs require.
Please Note: This position requires you to use your own personal computer or laptop. Tablets, iPads, and Chromebooks are not permitted.
Home Office Requirements:
- Internet speed of 25mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)
- Minimum 5mpbs upload speed
- Connectivity to the internet via Category 5 or 6 ethernet patch cable to the home router
- Personal computer or laptop (Chromebooks, tablets, and notebooks are not allowed) with one of the following operating systems: Windows: 10 or 11 or Mac: Big Sur (11.0.1+), Catalina (10.15), or Monterey (12.3)
- Private and secure work area and adequate power source
- Must currently and permanently reside in the Continental US
- Must have a smartphone which will be required to log into Maximus systems
EEO Statement
Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
For positions on this contract, Maximus will pay the prevailing wage rate for the location in which the employee is working, as determined by the Department of Labor. That wage rate will vary depending on locality. An applicant's salary history will not be used in determining compensation.
Accommodations
Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at applicantaccom@maximus.com.
Minimum Salary
$
34.85
Maximum Salary
$
68.55

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