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

Ad Hoc

Program Manager

Washington, DC · Remote

Program Manager This is a remote position. Ad Hoc is a technology company that empowers ... Manages planned contract revenue, billable utilization, and gross margin achievement * Exhibits ...

New

ColonialWebb

Service Estimator

Gaithersburg, MD · On-site +1

$75K - $95K/yr

This role can be remote or hybrid, based on your location! Who we are: At ColonialWebb, we are ... Manage a daily review of all open quotes, tracking each by submission date, and completing ...

SOSi

DoD SkillBridge Logistics Manager

Reston, VA · On-site +1

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

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How much do remote utilization review jobs pay per hour?

As of May 30, 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 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 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.
More about Remote Utilization Review jobs
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What cities near Reston, VA are hiring for Remote Utilization Review jobs? Cities near Reston, VA with the most Remote Utilization Review job openings:
Remote Utilization Review jobs near you
Commercial Lines Associate Broker (East Coast hybrid or remote)

Commercial Lines Associate Broker (East Coast hybrid or remote)

National Financial Partners

Reston, VA • On-site, Remote

$60K - $70K/yr

Full-time

Medical, Retirement, PTO

Posted 12 days ago

Job description

Who We Are:
NFP, an Aon company, is a multiple Best Places to Work award winner in Business Insurance who has also earned the WORK180 employer endorsement. We are an organization of consultative advisors and problem solvers. We help companies and individuals around the globe address their most significant risk, workforce, wealth management and retirement challenges through custom solutions and a people-first approach. To learn more, please visit: https://www.NFP.com.
Job Summary:
The Commercial Lines Associate Broker will provide support to broking team members and contribute to strategic recommendations, problem-solving, and solution development for prospects and clients. You will develop a comprehensive understanding of prospect and client risk profiles and exposures, and act to cultivate and maximize insurance market interest, leading to the development of effective risk financing and risk transfer solutions. Your focus will be on tailoring required coverage, terms and conditions, and developing the appropriate program architecture and design.
This is an ideal role for emerging talent with insurance experience and insights to foster a Broker career.
This is a full-time role with the flexibility of a hybrid schedule in our Bethesda, MD or Charlotte, NC office. We will consider a remote option for well-experienced candidates. East Coast work location is desired for the ability to travel within the region as required.
Essential Duties and Responsibilities:
  • Participate in the analysis of clients' or prospects' existing programs and ensure requirements. Review current policies and formulate recommendations for customized risk solutions.
  • Work with Sr. Broker and brokerage team to ensure placements are handled according to NFP's service model standards and timelines.
  • Support the team in developing client/prospect diagnostics working at the direction of the Broker or Senior Broker to complete a total program assessment, including total cost of risk, service deliverables, and opportunities for multi-faceted program improvement.
  • Assist in the timely production of required documentation and follow-up, ensuring timely flow of materials.
  • Assist team members with proposal development for existing and prospective clients.
  • Respond to client queries and concerns to resolve issues promptly.
  • Work with Sr. Broker to review binders and policies to ensure terms and conditions are accurately reflected.
  • Present to local account executives at occasional client meetings and conference calls.
  • Support the deployment of data and analytics to provide program insights for clients and the broking team.
  • Develop productive business relationships with key insurance underwriters and local NFP account teams.
  • Cultivate a thorough understanding of markets to better assist the broking team.
  • Execute on NFP's broking strategies, including strategic carriers, panels, and preferred wholesaler utilization.
  • Develop and maintain a thorough knowledge of the insurance marketplace, and the various lines, products and services offered by various insurers.
  • Ensure client, broking and brokerage data files are maintained in a complete, organized and timely fashion.
Knowledge, Skills, and/or Abilities:
  • Strong written and verbal communication skills. Strong attention to detail, demonstrating reliability and accuracy
  • Ability to successfully interact with a variety of people while demonstrating self-confidence and influence
  • Solid negotiation skills ability to adjust approach to effectively drive optimal outcomes depending on different personalities
  • Demonstrated ability to work independently and as part of a team
  • Strong organizational skills with the ability to adjust to changing workload and priorities
  • Able to coordinate resources and responsibilities
  • Self-motivated with positive attitude and sense of urgency
  • Detail-oriented with strong analytical skills, both quantitative and qualitative
  • Demonstrated knowledge of Microsoft Office Suite, MS Teams and AI at the intermediate or advanced level
  • Experience with Epic (agency management system) a plus
Education and/or Experience:
  • 2+ years of experience in commercial P&C broking, operations, underwriting or sales support is required
  • Bachelor's degree preferred. HS Diploma or equivalent along with P&C experience and additional training is required
  • Working knowledge of carrier underwriting practices and processes preferred
Certificates, Licenses, Registration:
  • P&C License required or obtained within 90 days of employment
  • Advanced industry designation(s) (e.g. CPCU, CIC, ARM) a plus
What We Offer:
We're proud to offer a competitive salary, PTO & paid holidays, 401(k) with match, exclusive discount programs, health & wellness programs, and more. Our PeopleFirst culture focuses on building and nurturing lifelong relationships with our employees because, at the end of the day, we exist to be there for others. The base salary range for this position is $60,000 $70,000. The base salary offered will be determined by factors including, but not limited to, experience, credentials, education, certifications, skill level required for the position, the scope of the position, and geographic location. Actual base salary offered will be determined on a case-by-case basis. In addition to the base salary, this position may be eligible for performance-based incentives.
NFP and You... Better Together!
NFP is an inclusive Equal Employment Opportunity employer.

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