ZipRecruiter

Log In

1

Utilization Review Rn Jobs in Arlington, VA (NOW HIRING)

The Excalibur Group

Registered Nurse I

Washington, DC · On-site

Registered Nurse I Location: Washington, DC About the Role: The Registered Nurse I provides ... Clinical experience in orthopedics, neurology, rehabilitation, or utilization review. Knowledge of ...

New

The Excalibur Group

Registered Nurse I

Washington, DC · On-site

Registered Nurse I Location: Washington, DC About the Role: The Registered Nurse I provides ... Clinical experience in orthopedics, neurology, rehabilitation, or utilization review. Knowledge of ...

New

Greenlife Healthcare Staffing

Be Seen First

Registered Nurse I

Washington, DC · On-site

$52/hr

Registered Nurse I - Washington, DC (#R10290) * Location: Washington, DC 20001 * Employment Type ... Clinical experience in orthopedics, neurology, rehabilitation, or utilization review. * Skills:

August Healthcare at Iliff

MDS Coordinator (RN)

Dunn Loring, VA · On-site

$37.25 - $45.25/hr

Lead or participate in PPS, Medicare, and utilization review meetings * Ensure timely completion ... Current, active RN license in the state * Minimum three (3) years of clinical experience; long-term ...

August Iliff

MDS Coordinator (RN)

Dunn Loring, VA · On-site

$37.25 - $45.25/hr

... utilization review meetings • Ensure timely completion, validation, and transmission of all MDS assessments • Collaborate with therapy, nursing, and interdisciplinary team members on ARDs and ...

previous pagenext page

Showing results 21-40

All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Arlington, VA

Utilization Review Rn information

See Arlington, VA salary details

$24

$48

$79

How much do utilization review rn jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for utilization review rn in Arlington, VA is $48.72, according to ZipRecruiter salary data. Most workers in this role earn between $38.51 and $55.96 per hour, depending on experience, location, and employer.

What is a utilization review RN?

A Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services and treatments provided to patients. They review medical records, collaborate with healthcare teams, and ensure that patient care meets established guidelines and payer requirements. Their role helps control costs, optimize care, and support compliance with healthcare regulations. Utilization Review RNs often work in hospitals, insurance companies, or managed care organizations.

How does a utilization review RN collaborate with physicians and other healthcare professionals during the patient care review process?

A Utilization Review RN works closely with physicians, case managers, and other healthcare team members to ensure that patients receive appropriate care while adhering to regulatory and insurance guidelines. This collaboration often involves discussing clinical findings, clarifying documentation, and negotiating care plans to meet both patient needs and payer requirements. Effective communication and teamwork are essential, as Utilization Review RNs frequently serve as liaisons between clinical staff and insurance representatives to facilitate timely authorizations and prevent unnecessary delays in patient care.

What are the key skills and qualifications needed to thrive as a utilization review RN, and why are they important?

To thrive as a Utilization Review RN, you need a current RN license, strong clinical assessment skills, and knowledge of healthcare regulations and insurance guidelines. Familiarity with utilization management software, electronic health records (EHRs), and relevant certifications like CCM or ACM is often required. Excellent critical thinking, communication, and negotiation skills help you advocate for appropriate patient care while collaborating with providers and payers. These skills ensure cost-effective, quality care and compliance with regulatory standards in healthcare delivery.

What is the difference between Utilization Review Rn vs Case Manager?

AspectUtilization Review RnCase Manager
CredentialsRN license, certifications in utilization reviewRN license, certifications in case management
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, community agencies, insurance companies
Primary FocusReviewing medical necessity and appropriateness of careCoordinating patient care and discharge planning

Utilization Review Rns primarily focus on evaluating the necessity of medical treatments, while Case Managers coordinate patient care and discharge planning. Both roles require RN licensure and certifications, but their daily responsibilities and work environments differ slightly, with Utilization Review Rns concentrating on review processes and Case Managers on patient advocacy and care coordination.

How to get into utilization review as a registered nurse?

To become a utilization review RN, you typically need a valid registered nurse license and experience in clinical settings. Additional certifications such as the Certified Professional in Healthcare Quality (CPHQ) or case management certification can enhance job prospects, and familiarity with electronic health records (EHR) systems is often required.

What are the most commonly searched types of Utilization Review Rn jobs in Arlington, VA?

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

What are popular job titles related to Utilization Review Rn jobs in Arlington, VA?

For Utilization Review Rn jobs in Arlington, VA, the most frequently searched job titles are:

What job categories do people searching Utilization Review Rn jobs in Arlington, VA look for?

The top searched job categories for Utilization Review Rn jobs in Arlington, VA are:

What cities near Arlington, VA are hiring for Utilization Review Rn jobs?

Cities near Arlington, VA with the most Utilization Review Rn job openings:

Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Arlington, VA as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 16% Part Time, 2% Contract, and 1% Nights. Highlights an 83% Physical, 2% Hybrid, and 15% Remote job distribution, with an average salary of $101,125 per year, or $48.6 per hour.

Registered Nurse I

Greenlife Healthcare Staffing

Washington, DC • On-site

$52/hr

Temporary

Posted 7 days ago

Job description

Registered Nurse I – Washington, DC

Location: Washington, DC
Employment Type: Temporary / Part-time (as-needed)
Rate: $52/hour

Position Overview:
The Registered Nurse provides medical case management for the Public Sector Workers' Compensation Program and Return-to-Work Program, including clinical assessment, care coordination, utilization review, medical documentation, and return-to-work planning.

Why You'll Love Working Here:
  • Competitive rate of $52/hour providing specialized medical case management for workers' compensation and return-to-work programs.
  • Temporary, part-time (as-needed) position.
  • Part-time / as-needed schedule, Monday–Friday.
  • No work on District holidays or administrative closure days without prior written approval.
  • Valuable experience in a collaborative, supportive government office setting.
  • Mission-driven work improving outcomes for injured workers through comprehensive medical case management and return-to-work planning.

Qualifications:
  • Graduation from an accredited professional nursing program recognized by the applicable state accrediting authority.
  • Current Registered Nurse license in the District of Columbia.
  • At least one year of specialized professional nursing experience involving medical assessment, planning, implementation, utilization review, and evaluation of patient progress.
  • Clinical experience in orthopedics, neurology, rehabilitation, or utilization review.
  • Skilled in clinical assessment, medical case management, care planning, and utilization review.
  • Knowledge of workers' compensation medical issues, healthcare regulations, return-to-work planning, and treatment review.
  • Medical-record analysis, professional documentation, and case-status reporting.
  • Proficiency with Microsoft Office and electronic medical or claims systems.
  • Analytical, interpersonal, presentation, and written and verbal communication skills.
  • Confidential information handling and privacy compliance.

Key Responsibilities:
  • Provide comprehensive medical case management for public-sector workers' compensation and return-to-work programs.
  • Assess injured workers' clinical status, treatment plans, functional abilities, and recovery progress.
  • Develop, implement, monitor, and revise individual case management plans that support recovery and safe return to work.
  • Coordinate care among injured workers, treating physicians, specialists, rehabilitation providers, employers, supervisors, claims examiners, and agency representatives.
  • Review medical records, treatment plans, utilization requests, and supporting documentation for medical necessity, appropriateness, and workers' compensation compliance.
  • Conduct utilization review, treatment-plan review, and medical-billing review.
  • Identify claims appropriate for return-to-work initiatives and support transitional duty assignments and workplace accommodations.
  • Establish return-to-work status, projected recovery timelines, maximum medical improvement targets, work restrictions, and functional capacity recommendations based on medical evidence and provider input.
  • Monitor injured workers before and after return to work and communicate case status and treatment progress to stakeholders.
  • Prepare medical status reports, case summaries, recommendations, and claim-support documentation.
  • Provide consultation, guidance, and training on medical management, return-to-work strategies, injury prevention, and transitional duty.
  • Present medical findings and professional recommendations during claim reviews, mediations, hearings, and other proceedings.
  • Maintain complete case records and safeguard confidential medical and personnel information.
  • Perform other related duties supporting the workers' compensation and return-to-work programs.

Greenlife Healthcare Staffing logo

About Greenlife Healthcare Staffing

Sourced by ZipRecruiter

Greenlife Healthcare Staffing is a nationwide recruitment agency, matching both new grads and advanced practitioners to hospitals, clinics, nursing homes, multi-specialty groups, and private practices.

Industry

Recruiting and staffing services

Company size

11 - 50 Employees

Headquarters location

New York, NY, US

Social media

FacebookTwitter

View All Greenlife Healthcare Staffing Jobs