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Remote Utilization Review Jobs in Virginia (NOW HIRING)

Sentara Healthcare

IT HEDIS & Analytics Manager

Norfolk, VA · On-site +1

$29.25 - $38.75/hr

For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland ...

Sentara Health

IT HEDIS & Analytics Manager

Norfolk, VA · On-site +1

$10K/mo

For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland ...

SAP

SAP NS2 Sr. DevOps Engineer

Herndon, VA · On-site +1

$133K - $171K/yr

SAP NS2 Senior DevOps Engineer - Remote COMPANY DESCRIPTION  SAP is the global market leader for ... utilization and implement cost-effective solutions • Maintain security best practices and ...

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All JobsUtilization Review JobsRemote Utilization Review JobsRemote Utilization Review Jobs in Virginia

Remote Utilization Review information

See Virginia salary details

$21

$41

$68

How much do remote utilization review jobs pay per hour?

As of Aug 16, 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 remote utilization review?

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 remote utilization review do?

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?

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 are popular job titles related to Remote Utilization Review jobs in Virginia?

For Remote Utilization Review jobs in Virginia, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Review jobs in Virginia look for?

The top searched job categories for Remote 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:

Remote Utilization Review jobs near you
Infographic showing various Remote Utilization Review job openings in Virginia as of August 2026, with employment types broken down into 86% Full Time, 11% Part Time, and 3% Contract. Highlights an 100% Remote job distribution, with an average salary of $87,192 per year, or $41.9 per hour.

Integrated Case Manager- RN (Chesapeake)

Sentara Healthcare

Virginia Beach, VA • On-site, Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 26 days ago

Sentara Health rating

6.7

Company rating: 6.7 out of 10

Based on 412 frontline employees who took The Breakroom Quiz

531st of 887 rated healthcare providers

Job description

City/State
Virginia Beach, VA
Work Shift
First (Days)
Overview:
Sentara Health is looking to hire an Integrated Case Manager, RN.
This is a remote position; however, candidates must reside in Suffolk, Norfolk, VA Beach, Portsmouth, VA and the surrounding areas as travel is required up to 1 hour to see members approximately 50 to 75% a week.
The Integrated Case Manager is responsible for case management services within the scope of licensure; develops, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of optimizing member health care across the care continuum. Performs telephonic or face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical and behavioral health, social services and long-term services.
Identifies members for high-risk complications and coordinates care in conjunction with the member and health care team. Manages chronic illnesses, co-morbidities, and/or disabilities ensuring cost effective and efficient utilization of health benefits; conducts gap in care management for quality programs. Assists with the implementation of member care plans by facilitating authorizations/referrals within benefits structure or extra-contractual arrangements, as permissible. Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on care management treatment plans. Presents cases at case conferences for multidisciplinary focus. Ensure compliance with regulatory, accrediting and company policies and procedures. May assist in problem solving with provider, claims or service issues.
Demonstrates the minimum knowledge, skills and abilities to care for the individualized needs of the patient to include physical, psychological, socio-cultural, spiritual and cognitive needs as well as functional abilities including the need for diversified use of such practices. Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills
Education:
  • Associates Degree required
  • Bachelors preferred

Certification:
  • Registered Nurse required

Experience:
  • 3 years of nursing experience required
  • Managed care preferred
  • Discharge planning experience preferred

Keywords: Talroo- Health, Case Management, Managed Care, Discharge Planning
Benefits: Caring For Your Family and Your Career
• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to 10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance - 5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down - 10,000
• Reimbursement for certifications and free access to complete CEUs and professional development
• Pet Insurance
• Legal Resources Plan
• Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission "to improve health every day," this is a tobacco-free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

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