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

Software Engineer, Medicaid

Arlington, VA · On-site

$100K - $120K/yr

Our entire team is remote across the United States, from the West Coast to the East Coast. There ... Contribute to the next version of the program's drug utilization review tools * Help lead the team ...

Our entire team is remote across the United States, from the West Coast to the East Coast. There ... Contribute to the next version of the program's drug utilization review tools * Help lead the team ...

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

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

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 ...

Showing results 41-60

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 Sep 3, 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 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 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 80% Full Time, and 20% Contract. Highlights an 100% Remote job distribution, with an average salary of $91,496 per year, or $44 per hour.

RN Health Specialist - CDC INFO (bilingual, remote, temporary)

Maximus

VA • On-site, Remote

Full-time

This job post has expired today. Applications are no longer accepted.


Maximus rating

6.8

Company rating: 6.8 out of 10

Based on 302 frontline employees who took The Breakroom Quiz

301st of 500 rated business services


Job description

General information
Job Posting Title
RN Health Specialist - CDC INFO (bilingual, remote, temporary)
Date
Friday, August 28, 2026
City
Remote
Country
United States
Working time
Full-time
Description & Requirements
Maximus is recruiting for a call center, Health Specialist (RN) Registered Nurse, to support our CDC INFO (Center for Disease Control) program.
CDC INFO is the CDC's national contact center, providing information to the public, healthcare providers, and public health professionals. CDC INFO offers customer service via phone, email, and chat to provide the most up-to-date, reliable, consistent, and science-based health information on more than 750 health and COVID related topics.
The ideal candidate will thrive in a fast-paced contact center environment and be comfortable handling health-related inquiries. Strong listening, communication, and research skills are essential to follow established scripts and protocols, navigate approved resources, and provide clear, accurate, and professional guidance while maintaining quality and compliance standards.
Training Schedule
Monday - Friday 8:00 AM to 4:30 PM Eastern Time
Work Schedule
Must be flexible and available to work
Monday - Friday
8:00 AM - 4:30 PM or
11:30 AM - 8:00 PM
- 100% attendance throughout the entire training period is required.
Equipment Requirements
This is a bring your own device position which requires you to provide your own Smart Phone, personal computer, webcam, & headset with microphone (Tablets, iPads, and Chromebooks are not permitted.)
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.
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.
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.
Education, Experience and Skills
- Experience in medical, scientific or public health discipline.
- Clinical knowledge of and experience with CDC related topics.
- Bachelor's Degree in Nursing and current, active RN license are required.
- 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.
- Call Center or Telehealth experience preferred.
- Must have a Smartphone which will be required only to log into Maximus systems,
not for daily work activities.
Equipment Requirements
This is a bring your own device position which requires you to provide your own Smart Phone, personal computer, webcam, & headset with microphone (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
- Hard-wired internet connectivity via Category 5 or 6 ethernet cable to the home internet router
- Private and secure work area and adequate power source
- Windows or Mac Operating Systems
OS for Windows - Windows 10 or Windows 11 (11 is preferred)
OS for Mac - Big Sur (11.0.1+); Catalina (10.15); Monterey (12.3)
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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