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Remote Utilization Review Jobs in Silver Spring, MD

Charter Global

Utilization Management

Reston, VA · Remote

Reston, VA (Remote) Duration: 3+ Months Contract PURPOSE: Supports the Utilization Management ... related to pre-service, utilization review, care coordination and quality of care. 3 years ...

CareFirst

Care Manager (Remote)

Baltimore, MD · Remote

... Utilization Review, Disease Management or other direct patient care experience. Bilingual - fluent in Spanish Preferred Qualifications: * Bachelors degree in nursing * CCM/ACM or other RN Board ...

CareFirst

Clinical Navigator (Remote)

Baltimore, MD · Remote

... and/or Utilization Review. Preferred Qualifications: * Knowledge and experience with MCG * Experience working with Commercial and Medicare/Medicaid enrollees and benefits contracts * CCM ...

CareFirst

Clinical Navigator (Remote)

Baltimore, MD · Remote

... Utilization Review. Preferred Qualifications: * Knowledge and experience with MCG * Experience working with Commercial and Federal Employee Program employee group member and Medicare/Medicaid ...

CareFirst

Clinical Navigator (Remote)

Baltimore, MD · Remote

Experience: 5 years clinically related experience working in Care Management, Home Health, Discharge Coordination and/or Utilization Review. Licenses/Certifications Upon Hire Required: * RN - ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Ashburn, VA · On-site +1

$58.50 - $71.25/hr

Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Silver Spring, MD · On-site +1

$59 - $72/hr

Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...

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Remote Utilization Review information

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$71

How much do remote utilization review jobs pay per hour?

As of Jun 10, 2026, the average hourly pay for remote utilization review in Silver Spring, MD is $43.71, according to ZipRecruiter salary data. Most workers in this role earn between $34.52 and $50.19 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 Silver Spring, MD? The most popular types of Utilization Review jobs in Silver Spring, MD are:
What are popular job titles related to Remote Utilization Review jobs in Silver Spring, MD? For Remote Utilization Review jobs in Silver Spring, MD, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review jobs in Silver Spring, MD look for? The top searched job categories for Remote Utilization Review jobs in Silver Spring, MD are:
What cities near Silver Spring, MD are hiring for Remote Utilization Review jobs? Cities near Silver Spring, MD with the most Remote Utilization Review job openings:
Remote Utilization Review jobs near you
Infographic showing various Remote Utilization Review job openings in Silver Spring, MD as of June 2026, with employment types broken down into 81% Full Time, 6% Part Time, and 13% Contract. Highlights an 100% Remote job distribution, with an average salary of $90,917 per year, or $43.7 per hour.
Utilization Management

Utilization Management

Charter Global

Reston, VA • Remote

Other

Posted 5 days ago

Job description

Job Title: Utilization Management

Location: Reston, VA (Remote)

Duration: 3+ Months Contract


PURPOSE:

Supports the Utilization Management clinical teams by assisting with non-clinical administrative tasks and responsibilities related to pre-service, utilization review, care coordination and quality of care.

3 years’ experience in health care/managed care setting or previous work experience within division

2 years of CPT and ICD-10 coding.

Previous authorization experience

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