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Remote Utilization Review Jobs in West Virginia (NOW HIRING)

GDIT

Healthcare Claims Data Analyst

WV · Remote

Exposure to fraud, waste and abuse, program integrity, payment integrity or utilization review work ... Remote Work Location: Any Location / Remote Additional Work Locations: Total Rewards at GDIT: Our ...

New

CSAA

Lead operational governance activities across assigned Clubs, including creative review oversight ... Track and monitor Club marketing funding utilization to ensure compliance with Producer Agreements

AmeriSave Mortgage Corp.

$60K - $120K/yr

Review loan application package for completeness and accuracy, reconcile application against system ... Utilization of AUSSIE and company procedures * Establish an ongoing relationship by delivering best ...

Bcbsa

$155K - $175K/yr

Analytics Team - Collaborate on drug trends and utilization data to inform clinical policy ... Clinical Team - Liaise with Clinical team to review clinical data and policy requirements as needed

Novolex

$89K - $115K/yr

Conduct business reviews and develop growth strategies to expand product adoption, category ... Remote Company BenefitsWhat You'll Get From UsBenefits With safety as our top priority and a ...

Novolex

$89K - $115K/yr

Conduct business reviews and develop growth strategies to expand product adoption, category ... Remote Company BenefitsWhat You'll Get From UsBenefits With safety as our top priority and a ...

GDIT

Healthcare Finance Lead

WV · Remote

$85K - $109K/yr

... utilization trends. * Oversee medical and pharmacy payments while reviewing underlying claims ... Remote Work Location: Any Location / Remote Additional Work Locations: Total Rewards at GDIT: Our ...

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

Remote Utilization Review information

See West Virginia salary details

$16

$32

$53

How much do remote utilization review jobs pay per hour?

As of Aug 9, 2026, the average hourly pay for remote utilization review in West Virginia is $32.73, according to ZipRecruiter salary data. Most workers in this role earn between $25.87 and $37.60 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 West Virginia? The most popular types of Utilization Review jobs in West Virginia are:
What are popular job titles related to Remote Utilization Review jobs in West Virginia? For Remote Utilization Review jobs in West Virginia, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review jobs in West Virginia look for? The top searched job categories for Remote Utilization Review jobs in West Virginia are:
What cities in West Virginia are hiring for Remote Utilization Review jobs? Cities in West Virginia with the most Remote Utilization Review job openings:
Remote Utilization Review jobs near you
Infographic showing various Remote Utilization Review job openings in West Virginia as of August 2026, with employment types broken down into 9% As Needed, 75% Full Time, 7% Part Time, and 9% Contract. Highlights an 59% In-person, and 41% Remote job distribution, with an average salary of $68,085 per year, or $32.7 per hour.

Healthcare Staffing Sales

Anderson Recruiting & Consulting

Charleston, WV • Remote

$49K - $64K/yr

Full-time, Contractor

Re-posted 9 days ago

Job description

healthcare Staffing Sales - Remote US

Our client is expanding their Science and Healthcare Practice and is looking for proven sales talent with experience selling RN Case Managers and Utilization Review RN's. They focus solely on Contract and Contract to Hire business nationally. They sell to Hospitals, Health Insurance Companies, Home Health, Nursing Facilities, along with many other Providers and Programs. Target is to average over 30% GM per placement on $1M+ in GM per year.

Offering a solid base salary + uncapped commissions, excellent benefits package with a lot of additional perks. Excellent leadership/training and growth opportunities.

For additional information/consideration, please apply.

#LI - CA1