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Utilization Review No Experience Jobs in Reston, VA

Greenlife Healthcare Staffing

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Registered Nurse I

Washington, DC · On-site

$52/hr

No work on District holidays or administrative closure days without prior written approval. * Work ... Clinical experience in orthopedics, neurology, rehabilitation, or utilization review. * Skills:

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Utilization Review No Experience information

See Reston, VA salary details

$22

$43

$71

How much do utilization review no experience jobs pay per hour?

As of Sep 3, 2026, the average hourly pay for utilization review no experience 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 utilization review?

Utilization review is a process used in healthcare to assess the necessity, appropriateness, and efficiency of the use of medical services, procedures, and facilities. Many entry-level utilization review positions are available for individuals with clinical backgrounds, such as nurses or social workers, even if they do not have prior experience in utilization review specifically. Employers often provide on-the-job training for candidates who understand medical terminology and have a background in healthcare. If you do not have a clinical license, you may need to seek administrative or support roles in utilization review to gain experience.

What are the key skills and qualifications needed to thrive as a utilization review specialist with no prior experience?

To thrive as a Utilization Review Specialist without prior experience, you generally need a healthcare-related degree, strong analytical skills, and a good understanding of medical terminology. Familiarity with case management software, electronic health records (EHR), and UR-specific platforms is typically required, and some roles may prefer candidates to pursue certification like Certified Utilization Review Specialist (CURA) over time. Attention to detail, effective communication, and strong organizational skills help new professionals excel in assessing medical necessity and collaborating with healthcare teams. These competencies ensure accurate reviews, regulatory compliance, and positive patient outcomes in a complex healthcare environment.

What are common challenges faced by entry-level professionals in utilization review and how can they be addressed?

Entry-level professionals in Utilization Review often face challenges such as learning complex medical terminology, understanding insurance regulations, and adapting to fast-paced review processes. To overcome these, it's helpful to seek mentorship from experienced team members, utilize available training resources, and stay organized with case management tools. Regular communication with clinical staff and supervisors also helps clarify protocols and expectations, making it easier to build confidence and competence in the role.

What is the difference between Utilization Review No Experience vs Utilization Review Coordinator?

AspectUtilization Review No ExperienceUtilization Review Coordinator
Required CredentialsHigh school diploma or equivalent; on-the-job trainingHigh school diploma; certification may be preferred
Work EnvironmentEntry-level, training-focused, healthcare settingsOffice-based, healthcare facilities, insurance companies
Employer & Industry UsageHospitals, insurance companies, healthcare providersInsurance companies, healthcare organizations, managed care
Search & Comparison IntentEntry-level, no experience, trainingCoordination, case management, healthcare review

Utilization Review No Experience roles are entry-level positions requiring minimal credentials and focus on training within healthcare settings. In contrast, Utilization Review Coordinators typically have some experience or certification, handling case management and review tasks in healthcare or insurance environments. Both roles are essential in healthcare utilization management but differ mainly in experience requirements and responsibilities.

Is utilization review a stressful job?

Utilization review can be stressful due to the need to evaluate medical cases accurately and efficiently while meeting strict deadlines. The role often involves high attention to detail, communication with healthcare providers, and managing workload, which can contribute to job-related stress. However, stress levels vary depending on the work environment and individual coping skills.

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 Utilization Review No Experience jobs in Reston, VA?

For Utilization Review No Experience jobs in Reston, VA, the most frequently searched job titles are:

What job categories do people searching Utilization Review No Experience jobs in Reston, VA look for?

The top searched job categories for Utilization Review No Experience jobs in Reston, VA are:

What cities near Reston, VA are hiring for Utilization Review No Experience jobs?

Cities near Reston, VA with the most Utilization Review No Experience job openings:

Utilization Review No Experience jobs near you
Infographic showing various Utilization Review No Experience job openings in Reston, VA as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $91,496 per year, or $44 per hour.

RN Reviewer/ Workers' Compensation Utilization Review - REMOTE

MICHIGAN PEER REVIEW ORGANIZATION

Washington, DC • Remote

Contractor

Posted yesterday

New

Job description

iMPROve Health is seeking an RN Reviewer (Workers' Compensation Utilization Review) to serve as an independent contractor (1099) performing independent external medical reviews remotely on an ad hoc basis.  As a peer reviewer, you will apply your clinical expertise to evaluate cases, specific to your specialty, medical necessity and/or standard of care, supporting efforts to enhance the overall quality and integrity of health care and your profession. Please note, this is not an employed position and our contracted fee is based on credential and specialty type.

BENEFITS:

  • Make a Difference: Use your clinical knowledge to improve the quality of care patients receive.
  • Professional Recognition: Join a network of highly respected experts in your specialty.
  • Competitive Compensation: Receive fair pay for your time and expertise.
  • Protect Standards of Care: Help uphold the integrity of your profession.
  • Work Remotely: Review cases from the convenience of your home or office.
Qualifications

  • Active, unrestricted RN license required; New York RN license strongly preferred.
  • Minimum three (3) years of experience in workers' compensation, utilization review, case management, or occupational health.
  • Working knowledge of Workers' Compensation Medical Treatment Guidelines and evidence-based clinical criteria.
  • Strong clinical assessment, critical thinking, and written communication skills.
  • Experience reviewing medical records and determining medical necessity preferred.

Responsibilities

  • Review treatment requests and medical records for medical necessity and guideline compliance.
  • Apply Workers' Compensation Medical Treatment Guidelines and applicable regulatory requirements.
  • Prepare clear, objective, and timely review determinations.
  • Maintain confidentiality and comply with HIPAA and other applicable privacy requirements.

Technical Requirements

  • Reliable high-speed internet/Wi-Fi connection.
  • Secure home office environment with the ability to protect confidential information.
  • Proficiency using web-based review platforms and Microsoft Office applications.

OTHER REQUIREMENTS:

  • Must complete the electronic credentialing application and receive organizational approval prior to performing a case review.
  • Must complete a conflict of interest attestation upon credentialing and prior to performing a case review.
  • Active hospital medical staff privileges may be required, as applicable.
  • Notify the organization in a timely manner of an adverse change in licensure or certification status, including board certification status.

EOE/VET/Disability