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Remote Utilization Review Rn Jobs in Springfield, VA

Centerbrite

BCBA (Part-time) (Remote)

Fairfax, VA · 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 ...

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Remote Utilization Review Rn information

See Springfield, VA salary details

$22

$44

$72

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

As of Sep 7, 2026, the average hourly pay for remote utilization review rn in Springfield, VA is $44.16, according to ZipRecruiter salary data. Most workers in this role earn between $34.90 and $50.72 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 Springfield, VA?

For Remote Utilization Review Rn jobs in Springfield, VA, the most frequently searched job titles are:

What cities near Springfield, VA are hiring for Remote Utilization Review Rn jobs?

Cities near Springfield, 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 Springfield, VA as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 18% Part Time, 3% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $91,862 per year, or $44.2 per hour.

Disease Management RN (Regional Care Coordinator)

SLT Health Consulting

Rockville, MD • Remote

Full-time

Re-posted 7 days ago

Job description

The Regional Care Coordinator (RCC) is assigned to a geographic region and is highly familiar with the region they service. The RCC is also responsible for overseeing the Patient Centered Medical Home (PCMH) Program and acts as the liaison between the Primary Care Physician and CareFirst Blue Cross Blue Shield. The RCC will identify and resolve problems and use all available resources/programs to assist the high risk patient population.

The RCC:

  • Functions as a subject matter expert in the PCMH concept and protocols
  • Leads RNs and performs oversight of the RNs and the team functions.
  • Acts as a front line resource proactively educated on the use of high quality, cost-efficient resources and specialty care networks.

This is a work from home and work in the physician's office position (remote). Succesful candidate will work autonomously in an exempt, Monday through Friday capacity.

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