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Remote Utilization Review Jobs in Reston, VA (NOW HIRING)

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 ...

Overview Safety Manager US Remote Emmes Group: Building a better future for us all. Emmes Group is ... Reviews safety events. * Oversees the collection, assessment, monitoring, review and reporting of ...

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

S. leadership in the research, development, validation, and effective utilization of energy ... Benefits MELE Offers · Hybrid remote/office work environment. · Employer-paid employee Medical ...

Hybrid - onsite and remote Responsibilities * Plan, manage, and execute all aspects of life-cycle ... Secure resources and ensure proper utilization to meet budgetary requirements. * Allocate team ...

Showing results 41-60

Remote Utilization Review information

See Reston, VA salary details

$22

$43

$71

How much do remote utilization review jobs pay per hour?

As of Aug 18, 2026, the average hourly pay for remote utilization review in Reston, VA is $43.99, according to ZipRecruiter salary data. Most workers in this role earn between $34.76 and $50.53 per hour, depending on experience, location, and employer.

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 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 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 are the most commonly searched types of Utilization Review jobs in Reston, VA?

The most popular types of Utilization Review jobs in Reston, VA are:

What are popular job titles related to Remote Utilization Review jobs in Reston, VA?

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

What job categories do people searching Remote Utilization Review jobs in Reston, VA look for?

The top searched job categories for Remote Utilization Review jobs in Reston, VA are:

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

Cities near Reston, VA with the most Remote Utilization Review job openings:

Infographic showing various Remote Utilization Review job openings in Reston, VA as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 13% Part Time, 4% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $91,496 per year, or $44 per hour.

Program Manager (Remote)

Acquisition Professionals LLC

Washington, DC • Remote

$115K - $130K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 19 days ago


Job description

Corporate Profile:Acquisition Professionals (AP) LLC is a trusted strategic partner and solutions-based company that combines years of deep knowledge-based expertise, agile program management, and customized learning solutions, AP provides cradle-to-grave acquisition services and acquisition training; administrative support services; Information Technology Support Services and program and financial management. We leverage technology, tools, and industry best practices through our experienced personnel to create cross-functional results and navigate the complex and high-risk areas for our clients' projects and programs.Job Summary: The Program Manager oversees complex contracts, projects, budgets, and resources, ensuring successful delivery of contractual requirements and operational objectives. This role requires expertise in client relationship management, financial oversight, risk identification and mitigation, strategic planning, and performance management. The individual provides leadership and technical guidance to project teams, establishes quality and productivity standards, manages multiple concurrent projects, and serves as a trusted advisor to clients by understanding their business needs, setting expectations, and driving customer satisfaction. The successful candidate must be able to work independently with minimal supervision while ensuring compliance, accountability, and measurable results.Responsibilities:Serve as the primary point of contact for the Contracting Officer (CO) and Contracting Officer's Representative (COR) for all contract activities.Provide overall leadership, management, and oversight of all contractor personnel, task orders, contract deliverables, schedules, budgets, and performance.Plan, organize, direct, coordinate, and monitor acquisition support services across the full acquisition lifecycle, including acquisition planning, market research, source selection, contract administration, policy support, training, and data analytics.Ensure all contract requirements, deliverables, and performance metrics are completed on time, within scope, and in compliance with FAR, HSAR, HSAM, FAM, and FEMA policies.Manage contract resources, funding, budgets, labor utilization, and financial reporting using complex reporting mechanisms.Lead and oversee multiple concurrent projects and acquisition support efforts of varying complexity.Provide technical direction, guidance, and quality oversight to contractor staff and subcontractors.Develop and implement quality control, productivity, and performance standards to ensure successful contract execution.Monitor project risks, identify mitigation strategies, and resolve issues affecting cost, schedule, or performance.Manage client relationships, including understanding stakeholder missions and objectives, setting expectations, facilitating communication, and ensuring customer satisfaction.Support strategic acquisition planning, procurement forecasting, investment reviews, and program management initiatives.Oversee the preparation and submission of required reports, including biweekly progress reports, ad hoc reports, dashboards, performance metrics, and project closeout reports.Ensure compliance with onboarding, knowledge transfer, transition, continuity of operations, security, and training requirements.Coordinate contractor participation in progress meetings, technical discussions, acquisition reviews, and executive-level briefings.Maintain accountability for contract performance, staffing, employee supervision, performance evaluations, and workforce management.Ensure successful transition of services to the Government or successor contractor at contract completion.Education/Certifications:Bachelor's degree in Computer Science, Information Systems, Engineering, Business, Education, Management Sciences, Psychology, Human Resources Development/ Management, or other related discipline or equivalent experience in a technical or business discipline.Corporate Summary:Acquisition Professionals (AP) LLC is an Economically Disadvantaged, Woman-Owned small business. Acquisition Professionals LLC was founded in 2014 by President/CEO Luwanna K. Clark. We offer a competitive salary and compensation benefits package, including medical, dental, vision, disability, matching 401k, tax free transit subsidy, paid federal government holidays and paid time off. AP is an Equal Opportunity and Affirmative Action Employer and are committed to creating an all-inclusive environment for all employees. We do not tolerate discrimination or harassment of any kind.