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Remote Utilization Review Rn Jobs in Reston, VA (NOW HIRING)

Nurse Educator (USA Remote)

Washington, DC ยท On-site +1

$75K - $126K/yr

Experience a remote-first culture that empowers you to work with purpose and accountability in a ... Active, unrestricted RN license. * Bachelor's degree in Nursing (BSN). * 5+ years of clinical ...

Physician Advisor (Remote)

Manassas, VA ยท Remote

$250K - $350K/yr

... across Utilization Management (UM), Clinical Documentation Integrity (CDI), Coding, and Case ... Perform medical necessity reviews using MCG and/or InterQual * Support CMS compliance, including ...

BCBA (Part-time) (Remote)

Fairfax, VA ยท Remote

$80 - $110/hr

BCBA (Board Certified Behavior Analyst) - Part-time $80110/hr Flexible Schedule Hybrid (Remote + In ... Own documentation quality , utilization reviews, and oversight of treatment plans * Supervise RBTs ...

RN Field Case Manager

Washington, DC ยท 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 ...

RN Field Case Manager

Fairfax, VA ยท 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

Washington, DC ยท 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 ...

RN Field Case Manager

Fairfax, VA ยท 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 ...

Showing results 21-40

Remote Utilization Review Rn information

See Reston, VA salary details

$22

$43

$71

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

As of Aug 12, 2026, the average hourly pay for remote utilization review rn 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 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 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 Reston, VA? For Remote Utilization Review Rn jobs in Reston, VA, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review Rn jobs in Reston, VA look for? The top searched job categories for Remote Utilization Review Rn jobs in Reston, VA are:
What cities near Reston, VA are hiring for Remote Utilization Review Rn jobs? Cities near Reston, VA with the most Remote Utilization Review Rn job openings:
Infographic showing various Remote Utilization Review Rn job openings in Reston, VA as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 15% Part Time, and 2% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $91,496 per year, or $44 per hour.

Advanced Practice Registered Nurse (AGNP or FNP) (Remote)

Sunday Health

Washington, DC โ€ข Remote

Part-time

Re-posted 17 days ago


Job description

Type: Part-time, 1099

Location: Hybrid, ability to be in an in-office location 1-2 days per week

About Sunday Health

Sunday Health is dedicated to transforming cognitive health outcomes by focusing on early identification and intervention for those at risk of developing and those experiencing cognitive decline. We aim to address the significant lack of access to high-quality, comprehensive brain health services by providing cutting-edge diagnostics and novel therapies for individuals with mild cognitive impairment and mild dementia. Our mission is to bridge the gap in brain health services, ensuring timely, effective, and accessible care to help patients optimize their cognitive well-being while offering informed support to their loved ones.

Sunday Health is reimaging how care is provided and the structure of the clinical team. We believe in an NP-led model with consulting neurologists where each patient and caregiver dyad is assigned a dedicated care navigator to partner with them throughout their journey. We believe in meeting people where they are and offer remote first care with opportunities for in-person visits.

About the APRN role

Sunday Health is seeking an Advanced Practice Registered Nurse (APRN) to care for people at risk of developing, and those experiencing cognitive decline and their loved ones. This includes 1) individuals who are interested in understanding their current brain health and how they can promote their brain health as they age; 2) those who are experiencing symptoms of cognitive decline and seeking a diagnostic evaluation and early intervention to delay disease progression; and, 3) those with an established diagnosis of mild cognitive impairment or mild dementia who are seeking early intervention to delay disease progression and tailored care plans.

This is an exciting opportunity for an APRN to embark on a great journey with a company dedicated to improving access and care for this underserved population with strong administrative support to grow the practice in a unique model.

Responsibilities:

  • Direct Patient Care:
    • Provided exceptional clinical customer service by delivering thoughtful and comprehensive patient and caregiver-centered care in a hybrid environment.
    • Performing new and follow-up patient visits, including acquiring a cognition-focused history, completing cognitive, psychological, behavioral, functional, and caregiver assessments, ordering and interpreting labs and imaging, and developing care plans.
    • Implement medication treatment plans for mild cognitive impairment and mild dementia.
    • Empowering individuals with cognitive decline and their loved ones by providing patient education, anticipatory guidance, and tactical strategies to manage psychological symptoms and behavioral changes.
    • Build partnerships and collaborate with primary care providers and specialists to eliminate gaps in care and improve patient outcomes.
  • Clinical Operations and Quality of Care:
    • Provide feedback to the engineering, product, and operations team to improve care delivery and patient and clinical team experience.
    • Partner with the lead neurologist and other clinical team members to develop clinical pathways, protocols, and mechanisms for collecting and analyzing data to provide high-quality, evidence-based care in an evolving landscape.
    • Participate in clinical meetings and present cases for discussion and continuous learning.

Qualifications:

  • Education & Licensure:
    • MSN or DNP.
    • Certified AGNP or FNP.
    • Active, unrestricted license in DC, other states a plus, including Maryland and Virginia; open to attaining licenses, if necessary.
  • Qualities:
    • Emotional intelligence.
    • Curiosity and creativity.
    • Flexibility and resourcefulness.
  • Experience (2+ years):
    • Evaluating patients with neurocognitive disorders, ideally mild cognitive impairment and dementia.
    • Performing cognitive assessments and neurological exams.
    • Partnering with patients and loved ones to create tailored care plans.
    • Maintaining a strong evidence-based clinical skill set while practicing and implementing outcome-focused care.
    • Learning various technology systems and tools.
    • Delivering telehealth services a strong plus.
    • Working within a startup or highly dynamic environment a strong plus.

The ideal candidate will have a flexible entrepreneurial spirit and thrive in a fast-paced startup environment. They should be patient-centric, self-motivated, energetic, and comfortable working in a hybrid environment.