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Remote Utilization Review Rn Jobs in Ashburn, VA

Centerbrite Health

BCBA

Fairfax, VA · On-site +1

$90K - $110K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Own documentation quality , utilization reviews, and oversight of treatment plans * Supervise RBTs ... Remote and in-clinic Job Types: Full-time

Capstone Search Group

Be Seen First

Small Group Employee Benefits Consultant - Remote (10269)

Washington, DC · Remote

$85K - $100K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

About the Role 100% remote opportunity for an insurance professional knowledgeable with group ... Review current programs, evaluate claims and utilization data * Take proposals to market to help ...

New

WearLinq

Holter/Cardiac Technologist

Rockville, MD · On-site +1

$22/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... RN and LPNs with experience in ECG assessment, evaluation of arrhythmia and a thorough respect for accurate data processing and comprehensive reporting. * A minimum of 1+ years working in a remote ...

Wearlinq

Holter/Cardiac Technologist

Rockville, MD · On-site +1

$22/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... RN and LPNs with experience in ECG assessment, evaluation of arrhythmia and a thorough respect for accurate data processing and comprehensive reporting. * A minimum of 1+ years working in a remote ...

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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 Aug 20, 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 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 are the key skills and qualifications needed to thrive as a remote utilization review RN?

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 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 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 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 August 2026, with employment types broken down into 33% Full Time, 33% Part Time, and 34% Contract. Highlights an 100% Remote job distribution, with an average salary of $89,934 per year, or $43.2 per hour.

Nurse Practitioner - Medical Case Reviewer - Rockville, MD

Prime Physicians

Rockville, MD • Remote

$113K - $143K/yr

Contractor

Re-posted 22 days ago

Job description

Prime Physicians is a physician-led, The Joint Commission (TJC) Accredited, ISO 9001 certified and CMMI Level 3 appraised organization. Our commitment extends beyond traditional consulting and management services, offering comprehensive solutions to hospitals, health systems, and federal government agencies. At the heart of our operations is the ultimate goal to deliver high-quality patient care. Driven by a mission to catalyze healthcare transformation and innovation, we offer an array of services designed to redefine the healthcare landscape. From program and project management to strategic planning, we enhance operational efficiency and streamline business processes. With Prime Physicians, the future of patient care is in skilled and dedicated hands, leading the way towards a more efficient, effective, and compassionate healthcare system.

Job Title: Nurse Practitioner — Medical Case Reviewer

Specialty: Family, Adult-Gerontology, Pediatrics, or similar
Place of Work: Remote (U.S. only)
Duration: 6 months contract with a possibility of 6 months extensionLicense/Certifications: Active NP license, national certification (FNP-C, AGNP-C/BC, PNP-BC, etc.)
Education: Master’s or Doctorate in Nursing from accredited U.S. program
Minimum Qualification/Experience: At least 5 years of advanced practice clinical experience
Responsibilities:

  • Perform comprehensive chart reviews of medical records for HRSA programs, focusing on medical history, diagnosis, and treatment patterns.
  • Summarize findings into structured reports that support physician reviewers and program determinations.
  • Identify gaps in documentation and communicate the need for additional records when necessary.
  • Maintain consistency and accuracy while adhering to established templates and timelines. Collaborate with internal quality teams to refine processes and meet program standards.
  • Safeguard patient confidentiality and comply with all applicable legal and ethical guidelines.

Prime Physicians is a physician-led, The Joint Commission (TJC) Accredited, ISO 9001 certified and CMMI Level 3 appraised organization. Our commitment extends beyond traditional consulting and management services, offering comprehensive solutions to hospitals, health systems, and federal government agencies. At the heart of our operations is the ultimate goal to deliver high-quality patient care. Driven by a mission to catalyze healthcare transformation and innovation, we offer an array of services designed to redefine the healthcare landscape. From program and project management to strategic planning, we enhance operational efficiency and streamline business processes. With Prime Physicians, the future of patient care is in skilled and dedicated hands, leading the way towards a more efficient, effective, and compassionate healthcare system.