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Remote Utilization Review Rn Jobs in Ashburn, VA

Solvet

RN - Registered Nurse

Springfield, VA · On-site +1

... Review for Eligibility Support (CARES) program. Location: Remote with occasional onsite ... Active Virginia RN license (required). * BSN or MSN. * Minimum 2 years of experience in:

New

V-Tech Solutions Inc.

RN Care Manager

Washington, DC · Remote

$36.32 - $46/hr

The RN Care Manager assesses member needs, develops and monitors individualized care plans ... Identify gaps in care and address over- or under-utilization of services * Document care management ...

V-Tech Solutions Inc.

RN Care Manager

Washington, DC · Remote

$36.32 - $46/hr

The RN Care Manager assesses member needs, develops and monitors individualized care plans ... Identify gaps in care and address over- or under-utilization of services * Document care management ...

Central Intelligence Agency

Registered Nurse

Washington, DC · On-site +1

$103K - $112K/yr

Learn more about this agency Duties Help As a Registered Nurse for CIA, you will have diverse and ... Review our benefits Eligibility for benefits depends on the type of position you hold and whether ...

QTC

Registered Nurse

Mclean, VA · On-site +1

Provide support with chart reviews/documentation, scheduling and confirming appointments, answering ... Passing the NCLEX-RN (National Council Licensure Examination for Registered Nurses) * State nursing ...

Varsity Tutors

NCLEX-RN Tutor

Leesburg, VA · Remote

$18 - $40/hr

Adapts instruction using UWorld, Kaplan, or ATI practice question banks, content review materials, and test-taking strategy workshops to support BSN and ADN graduates preparing for registered nurse ...

Sedgwick

RN Field Case Manager

Washington, DC · Remote

$88K - $112K/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 ...

York Risk Services

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 ...

Sedgwick

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 ...

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All JobsUtilization Review Rn JobsRemote Utilization Review Rn JobsRemote Utilization Review Rn Jobs in Ashburn, VA

Remote Utilization Review Rn information

See Ashburn, VA salary details

$21

$43

$70

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

As of Jul 25, 2026, the average hourly pay for remote utilization review rn in Ashburn, VA is $43.24, according to ZipRecruiter salary data. Most workers in this role earn between $34.18 and $49.66 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 are popular job titles related to Remote Utilization Review Rn jobs in Ashburn, VA? For Remote Utilization Review Rn jobs in Ashburn, VA, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Ashburn, VA look for? The top searched job categories for Remote Utilization Review Rn jobs in Ashburn, VA are:
What cities near Ashburn, VA are hiring for Remote Utilization Review Rn jobs? Cities near Ashburn, VA with the most Remote Utilization Review Rn job openings:
Remote Utilization Review Rn jobs near you
Infographic showing various Remote Utilization Review Rn job openings in Ashburn, VA as of July 2026, with employment types broken down into 86% Full Time, 10% Part Time, and 4% Contract. Highlights an 59% Physical, 4% Hybrid, and 37% Remote job distribution, with an average salary of $89,934 per year, or $43.2 per hour.

Nursing Subject Matter Expert

R3 Management Services

Washington, DC • Remote

$17.50 - $20.50/hr

Part-time

Posted 5 days ago

Job description

Salary:

Nursing Subject Matter Expert

Position Overview

The Nursing Subject Matter Expert provides professional nursing expertise related to healthcare operations, clinical quality, medical-record review, program assessment, corrective-action monitoring, and technical assistance.

This position evaluates the effectiveness of nursing and healthcare-delivery operations across Job Corps centers and recommends improvements to the quality, safety, compliance, and consistency of student health services. This position may be part-time.

Key Responsibilities

  • Provide professional nursing consultation regarding adolescent and young-adult healthcare.
  • Monitor and evaluate the effectiveness of healthcare-delivery operations.
  • Review applicant and student health records and center recommendations.
  • Support clinical reviews involving enrollment decisions, healthcare needs assessments, medical separations, appeals, and complex health concerns.
  • Participate in comprehensive and targeted assessments of center health and wellness programs.
  • Review nursing documentation, medication-management practices, chronic-illness management, care coordination, immunization processes, preventive-health activities, and nursing operations.
  • Determine whether nursing and healthcare services meet professional, clinical, and program requirements.
  • Identify deficiencies and recommend corrective actions.
  • Review corrective action plans and monitor implementation.
  • Identify repeat findings and recommend additional corrective measures.
  • Provide virtual or onsite technical assistance to national, regional, and center health personnel.
  • Advise personnel on difficult nursing cases, chronic-disease management, preventive care, health education, and healthcare-delivery improvements.
  • Assist with developing or revising nursing policies, procedures, technical guides, training materials, and healthcare publications.
  • Conduct conference calls, webinars, consultations, and training for health and wellness managers, nurses, and other personnel.
  • Prepare assessment reports, record-review findings, recommendations, meeting notes, and monthly activity reports.
  • Coordinate with medical, mental health, substance-use prevention, and program-management personnel.
  • Protect confidential student, medical, and personal information.

Qualifications/Experience

  • Bachelor of Science in Nursing required.
  • Current Registered Nurse license.
  • Minimum of 5 years of experience monitoring the effectiveness of healthcare-delivery operations.
  • Experience with program evaluation and assessment.
  • Experience with quality and compliance assessment techniques.
  • Experience conducting medical-record reviews.
  • Knowledge of healthcare-delivery systems.
  • Knowledge of adolescent health and wellness issues.
  • Experience with crisis intervention.
  • Experience in clinical quality, case management, utilization review, public health, school health, community health, nursing administration, or residential youth healthcare is preferred.
  • Experience supporting multi-site or geographically dispersed healthcare operations is preferred.

Required Skills

  • Nursing operations and clinical oversight.
  • Healthcare quality and compliance.
  • Medical-record review.
  • Chronic-illness and case-management principles.
  • Program evaluation and assessment.
  • Corrective-action development and monitoring.
  • Adolescent and young-adult health.
  • Crisis intervention.
  • Health education and staff training.
  • Technical writing and report preparation.
  • Strong time-management and organizational skills.
  • Strong written and verbal communication.
  • Multidisciplinary collaboration.
  • Strong computer skills.

Certification

Must maintain a current Registered Nurse license. Bachelor of Science in Nursing is required. Certifications in case management, healthcare quality, public health nursing, nursing administration, or utilization review are preferred.

Clearance/Security

Must possess or be eligible to obtain and maintain a Public Trust clearance. Must comply with privacy, confidentiality, medical-record, and information-security requirements.

Salary

TBD