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Remote Utilization Review Jobs in Virginia (NOW HIRING)

Senior IT Project Manager

VA · On-site +1

$131K - $132K/yr

This is a remote position. Essential Duties and Responsibilities: - Manage multiple development ... Review product change requests, identify potential issues and communicate process changes ...

Remote, United States About the Company Athena Technology Group, Inc. (ATG) is a Service-Disabled ... reviews, operational plans, governance reviews, and compliance materials. Collect, analyze ...

The RN Triage and Transition is a remote position; however the caregiver must reside in Colorado or ... Conducts root cause analysis of extended post-acute stays, inappropriate utilization, readmissions ...

Remote, United States Employment Type: Full-Time Shift: Day Shift About the Company Athena ... Review, ITAM Operational Plan, and IT Governance and Compliance Review. Assess current ITAM ...

Financial Analyst

Herndon, VA · Remote

$119K - $199K/yr

Monitor financial performance and workforce utilization by tracking Minimum Standard Hours ... Experience supporting project closeouts and SLA reviews. Clearance Requirements: * Must have an ...

... utilization of logistics support services. Responsibilities: * Foster a team-oriented work ... Reviews and analyzes reports, such as revenue and performance records to recommended process ...

Program Budget Analyst

Chantilly, VA · On-site +1

$120K - $160K/yr

None Potential for Remote Work: ORA_ON_SITE Description SAIC is seeking a highly skilled Program ... utilization of financial resources in support of mission-critical programs. This role includes ...

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Showing results 1-20

Remote Utilization Review information

See Virginia salary details

$21

$41

$68

How much do remote utilization review jobs pay per hour?

As of Jul 5, 2026, the average hourly pay for remote utilization review in Virginia is $41.92, according to ZipRecruiter salary data. Most workers in this role earn between $33.12 and $48.12 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in the Remote Utilization Review position, and why are they important?

To thrive as a Remote Utilization Review professional, you need a solid foundation in clinical knowledge, critical thinking, and an active RN or LPN license, often supported by experience in case management or prior authorization. Familiarity with medical coding (ICD-10, CPT), electronic health records (EHRs), and utilization management software is typically required, along with URAC or related certifications. Excellent communication, attention to detail, and strong organizational skills help you efficiently manage cases and coordinate with providers and payers. These skills ensure accurate assessments of medical necessity, compliance with regulations, and effective remote collaboration with healthcare teams.

What does a typical day look like for someone in a Remote Utilization Review role?

A typical day for a Remote Utilization Review professional involves reviewing patient medical records, evaluating the necessity of proposed treatments against established guidelines, and collaborating with healthcare providers to gather additional information when needed. You will spend much of your time analyzing documentation, submitting recommendations, and ensuring that care authorization decisions align with payer policies and clinical best practices. Communication with case managers, physicians, and insurance representatives is frequent and essential. The work is generally independent and deadline-driven but requires strong teamwork and responsiveness through virtual meetings, emails, and calls.

What is a Remote Utilization Review job?

A Remote Utilization Review job involves assessing medical records and treatment plans to ensure they meet insurance guidelines and medical necessity criteria. Professionals in this role, often nurses or healthcare specialists, work remotely to review patient care for cost-effectiveness and compliance with policies. They collaborate with healthcare providers, insurance companies, and case managers to approve or deny services based on established guidelines. This position requires strong analytical skills, knowledge of medical policies, and attention to detail.

What are the most commonly searched types of Utilization Review jobs in Virginia? The most popular types of Utilization Review jobs in Virginia are:
What cities in Virginia are hiring for Remote Utilization Review jobs? Cities in Virginia with the most Remote Utilization Review job openings:
Infographic showing various Remote Utilization Review job openings in Virginia as of June 2026, with employment types broken down into 94% Full Time, and 6% Part Time. Highlights an 100% Remote job distribution, with an average salary of $87,192 per year, or $41.9 per hour.
Senior IT Project Manager

Senior IT Project Manager

Maximus

VA • On-site, Remote

$131K - $132K/yr

Full-time

Medical, Life, Retirement, PTO

Posted 26 days ago


Maximus rating

6.9

Company rating: 6.9 out of 10

Based on 292 frontline employees who took The Breakroom Quiz

243rd of 437 rated business services


Job description

General information
Job Posting Title
Senior IT Project Manager
Date
Wednesday, June 10, 2026
City
Remote
Country
United States
Working time
Full-time
Description & Requirements
Maximus is currently seeking a Senior IT Project Manager to lead and track the development and implementation of a complex, strategic initiative across multiple development or service teams. This role requires strong project management skills and the technical acumen to understand and coordinate system-level functions. The successful candidate will ensure alignment with strategic goals, manage dependencies, and support execution from planning through delivery.
This is a remote position.
Essential Duties and Responsibilities:
- Manage multiple development projects, development groups, and/or application support functions.
- Oversee the development and implementation of multiple, complex, organization-wide systems.
- Define and manage resource requirements and allocations.
- Develop and implement application programs.
- Manage operational leads on addressing issues relative to production and processing.
- Responsible for developing short-to-mid-term plans on how to optimize the project/program and the talent required to execute strategies for the area of responsibility.
- Typically responsible for providing guidance, coaching, and training to other employees within job area.
Job-Specific Essential Duties and Responsibilities:
- Direct, manage, and own enterprise-wide projects and initiatives, driving results, tracking and implementing against milestones, from original concept through final implementation.
- Build strong client relationships and serve as trusted advisor and effectively communicate with all levels of the organization, to include executive leadership and teams across Maximus.
- Define project scope, objectives, milestones, and tasks while maintaining Key Performance Indicators.
- Develop detailed work plans, schedules, project estimates, resource plans, and status reports.
- Execute resource plans to include the steps to identify, manage, report utilization and advocate for resources necessary to successfully resource and execute projects.
- Perform analysis to determine if timeframes required are sufficient to perform the tasks required.
- Conduct project meetings and maintain responsibility for project tracking and analysis.
- Review product change requests, identify potential issues and communicate process changes, enhancements, and modifications verbally or through written documentation to management, peers, staff, and other employees so that issues and solutions are understood.
- Provide oversight and management of sub-contractors, statement of work (SOW) and manage subcontractor budgets.
- Define the technological strategy in conjunction with the development team of each project: pipeline, tools, and key development procedures.
- Facilitates evaluation, recommendation, architecture and implementation of COTS, open-source software packages in the cloud, on SaaS, PaaS, IaaS environments.
- Oversee technical design documentation process for correctness and provide input to the other disciplines on the practicality of initial design goals and impact to the overall project timeline.
- Facilitate processes to identify high risk and software security postures for improvements, remediation, and corrective action.
- Review, edit and approve deliverables prepared by the project team and create / maintain documentation support including installation documents and other associated technical documents.
- Resolve, make recommendations, and escalate risks and issues using Risk Management best practices.
- Close out projects by capturing artifacts and best practices and facilitating lessons learned sessions.
- Other responsibilities as assigned.
Minimum Requirements
- Bachelor's degree in relevant field of study and 7+ years of relevant professional experience required, or equivalent combination of education and experience.
Job-Specific Minimum Requirements:
- Bachelor's degree with 7+ years of project management experience leading technology implementations in support of Business Operations projects with the ability to simultaneously deliver multiple small- and large-scale projects. Additional years of relevant experience will be considered in lieu of degree. Master's Degree preferred.
- Per customer requirements, United States citizenship is required.
- The ability to obtain and maintain a DoD-issued Secret security clearance.
- Project Management Professional Certification (PMP) is required.
- Ability to engage and collaborate across various business stakeholder teams to engage shared resources, subject matter experts, business SMEs, and decision makers to enable successful, timely and quality delivery of program/project initiatives.
- Ability to present and articulate project plans, status, challenges, and deployments objectively at all levels within the organization.
- Excellent client relationship development and management experience recommending, developing, and communicating approaches for resolving specific issues.
- Proven ability to use critical thinking skills, research and evaluate solution alternatives, coordinates technical discussions, and socialize recommendations based on project requirements.
- Excellent and holistic communication skills, including oral and written communication coupled with the proven ability to provide leadership and mentorship to existing team members.
Preferred Skills and Qualifications:
- Agile IT development / SCRUM Master experience preferred.
- Other professional certifications preferred (such as Six Sigma, ITIL, etc.).
- Experience with Federal Government contracting.
- Experience implementing Cybersecurity Maturity Model Certification (CMMC) framework, standards and best practices.
- Knowledge of Federal Security Protocols, including but not limited to NIST 800-171.
- Previous experience with full lifecycle deployment of O365 is preferred.
- Previous experience at the Sr. Manager level leading analytical and systematic evaluation of requirements to include business objectives, program processes and workflows, business rules, data management, interfaces, and maintenance to develop solution architecture preferred.
- Detailed knowledge and understanding of all aspects of program lifecycle including major initiatives such as cloud migration, software development, citizen engagement and delivery mission solutions preferred.
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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
Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.
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
$
140,000.00
Maximum Salary
$
160,000.00

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