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Remote Utilization Review Jobs in Washington (NOW HIRING)

J29 Inc.

Physician Auditor

Millersville, MD · On-site +1

$189K - $238K/yr

Remote Type: Part-Time *This position is contingent upon the successful award of the associated ... Minimum Requirements: * 10+ years clinical practice; experience in peer review, utilization review ...

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 ...

Ignite IT

Senior Network Security Engineer

Suitland, MD · Remote

$63 - $82.50/hr

... reviews, recertification, cleanup, and decommissioning. * Install, configure, maintain, patch ... remote users, certificates, authentication policies, availability, utilization, and user access ...

AHU Technologies Inc

Manufacturing Manager

Washington, DC · Remote

$40 - $45/hr

Prepare and review cost estimates, quotations, and pricing for machining jobs. Optimize production ... Monitor machine utilization, productivity, and performance metrics. Ensure adherence to safety ...

Lucyrx

Clinical Strategy Pharmacist

Bethesda, MD · On-site +1

$126K - $151K/yr

Lead formulary strategy development, including formulary design, tiering, utilization management ... Serve as a subject matter expert for P&T materials, clinical reviews, and formulary change ...

ICF

Enterprise Architect (MD DC VA) NI

Rockville, MD · On-site +1

$70.25 - $90.75/hr

* We are open to supporting 100% remote work anywhere within MD DC VA area * Local candidates may be ... Advisory & Governance Reviews * Provide strategic technical advisory services to programs and ...

Persado

Senior Account Manager

Washington, DC · On-site +1

$105K - $125K/yr

... review of compliance risks. Used by 8 out of the top 10 US banks today, the Persado platform ... This is a remote role, but candidates should be located on the East Coast, preferably within the ...

Persado

Senior Account Manager

Washington, DC · On-site +1

$105K - $125K/yr

... review of compliance risks. Used by 8 out of the top 10 US banks today, the Persado platform ... This is a remote role, but candidates should be located on the East Coast, preferably within the ...

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How much do remote utilization review jobs pay per hour?

As of Jul 13, 2026, the average hourly pay for remote utilization review in Washington is $47.89, according to ZipRecruiter salary data. Most workers in this role earn between $37.84 and $55.00 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 Washington? The most popular types of Utilization Review jobs in Washington are:
What are popular job titles related to Remote Utilization Review jobs in Washington? For Remote Utilization Review jobs in Washington, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review jobs in Washington look for? The top searched job categories for Remote Utilization Review jobs in Washington are:
What cities in Washington are hiring for Remote Utilization Review jobs? Cities in Washington with the most Remote Utilization Review job openings:
Remote Utilization Review jobs near you
Physician Auditor

Physician Auditor

J29 Inc.

Millersville, MD • On-site, Remote

$189K - $238K/yr

Part-time

Posted 4 days ago

Job description

Position: Physician Auditor - Contingent
Location: Remote
Type: Part-Time
*This position is contingent upon the successful award of the associated contract. Employment is not guaranteed until the contract is awarded, and the position is officially activated. Job responsibilities and requirements are subject to change.
About J29
J29 is an employee centered healthcare management consulting company that specializes in processing, reviewing, and analyzing medical claims, records, disputes, and audits. Established in 2017, J29 prides itself on its employee centric culture and high employee retention rates that allow us to ensure that we are creating a working environment that prioritizes the employee experience. Our team brings corporate performance that stretches to various areas where we can provide our clinical, healthcare policy, and compliance expertise through our support to health and human service programs at the State, Federal, and Commercial levels.
Responsibilities:
  • Perform blinded Independent Review (IRR) clinical evaluations, assessing medical necessity, appropriateness of care, and adherence to Medicare guidelines.
  • Collaborate in the development of rebuttals and contribute to informed escalation decisions as needed.
Minimum Requirements:
  • 10+ years clinical practice; experience in peer review, utilization review, or appeals
  • Familiarity with CMS/QIO processes preferred.
  • Licensed MD or DO in the U.S.; active, unrestricted license required.
J29, Inc. is committed to hiring and retaining a diverse workforce. We are proud to be an Equal Opportunity/Affirmative Action Employer, making decisions without regard to race, color, religion, creed, sex, sexual orientation, gender identity, marital status, national origin, age, veteran status, disability, or any other protected class. J29, Inc. is a proud Veteran friendly employer.
J29 logo

About J29

Sourced by ZipRecruiter

Industry

Business management consulting

Company size

1 - 10 Employees

Headquarters location

Millersville, MD, US

Year founded

2017

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