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Chart Utilization Review Jobs in Virginia (NOW HIRING)

The Utilization Review Coordinator assists admissions in screening patients at the pre-hospital ... Reviews that entire chart to evaluate the appropriateness of admission, continued stay, discharge ...

New

The Utilization Review Coordinator assists admissions in screening patients at the pre-hospital ... Reviews that entire chart to evaluate the appropriateness of admission, continued stay, discharge ...

New

... chart checking that documentation reflects and meets admission, continued stay, and discharge ... Three to five years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, ...

... chart checking that documentation reflects and meets admission, continued stay, and discharge ... Three to five years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, ...

... chart checking that documentation reflects and meets admission, continued stay, and discharge ... Three to five years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, ...

... chart checking that documentation reflects and meets admission, continued stay, and discharge ... Three to five years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, ...

Collaborates with Utilization Review Nurse. * Maintains regular contact with assigned Utilization ... Provides feedback to the health care team verbally and via chart entries regarding the patient ...

Collaborates with Utilization Review Nurse. * Maintains regular contact with assigned Utilization ... Provides feedback to the health care team verbally and via chart entries regarding the patient ...

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Chart Utilization Review information

What is chart utilization review?

Chart Utilization Review is a process commonly used in healthcare settings to assess the necessity, appropriateness, and efficiency of medical services provided to patients. It involves reviewing patient charts and medical records to ensure that treatments and procedures are justified according to established guidelines and policies. This process helps in improving patient care, managing costs, and ensuring compliance with regulatory requirements. Utilization review professionals work closely with medical staff, insurance companies, and regulatory agencies to support quality and cost-effective care.

What are some common challenges faced by professionals in chart utilization review, and how can they be addressed?

Professionals in Chart Utilization Review often encounter challenges such as navigating incomplete or inconsistent medical documentation, staying current with ever-evolving healthcare regulations, and balancing productivity with accuracy. To address these challenges, it is important to maintain open communication with clinical staff, participate in ongoing training, and utilize robust electronic health record systems. Additionally, collaborating closely with interdisciplinary teams can help clarify documentation and ensure compliance with regulatory standards.

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

To thrive as a Chart Utilization Review specialist, you need a background in healthcare, strong knowledge of medical terminology, and experience with patient care documentation, often supported by an RN or LPN license. Familiarity with utilization management software, electronic health records (EHR), and relevant certifications such as Certified Professional in Utilization Review (CPUR) are typically required. Attention to detail, analytical thinking, and effective communication are crucial soft skills for accurately reviewing charts and collaborating with healthcare providers. These abilities ensure compliance, optimize patient care, and support cost-effective healthcare delivery.

What is the difference between Chart Utilization Review vs Chart Review Specialist?

AspectChart Utilization ReviewChart Review Specialist
CredentialsTypically requires healthcare or insurance-related certificationsOften requires medical or coding certifications
Work EnvironmentHealthcare facilities, insurance companies, utilization management teamsMedical offices, insurance companies, coding firms
Employer & IndustryHospitals, insurance providers, healthcare organizationsMedical billing companies, insurance firms, healthcare providers
Primary FocusAssessing medical necessity and appropriateness of servicesReviewing medical records for coding accuracy and completeness

While both roles involve reviewing medical information, Chart Utilization Review focuses on evaluating the necessity of healthcare services, whereas Chart Review Specialists primarily verify medical documentation for coding and billing accuracy. Understanding these distinctions helps professionals choose the right career path or job search focus.

What cities in Virginia are hiring for Chart Utilization Review jobs?

Cities in Virginia with the most Chart Utilization Review job openings:

Infographic showing various Chart Utilization Review job openings in Virginia as of August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 20% Part Time, 2% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution.

PHP Utilization Review Coordinator

UHS

Leesburg, VA • On-site

$64K/yr

Full-time

Medical, Retirement, PTO

This job post has expired today. Applications are no longer accepted.


Universal Health Services rating

6.9

Company rating: 6.9 out of 10

Based on 254 frontline employees who took The Breakroom Quiz

454th of 893 rated healthcare providers


Job description

Responsibilities
***Join Our Team as a Utilization Review Coordinator!***
North Spring Behavioral Healthcare is looking for a fulltime Utilization Review Coordinator (on-site) to join our compassionate and dynamic team!
What We Offer:
  • Competitive Salary
  • Comprehensive Benefits Package:
    • Health insurance - Available after just 30 days.
    • Paid Time Off - Start earning after 90 days.
    • 401(k) with company match - Eligible after 30 days.
The Utilization Review Coordinator assists admissions in screening patients at the pre-hospital level to ensure that admission criteria are met, and when admitted, follows the chart checking that documentation reflects and meets admission, continued stay, and discharge criteria. Interacts and communicates with clinical staff, Business Office, Admissions, Medical Records, third party reviewers and hospital administration to help receive hospital care they need.
Key Responsibilities:
  • Performs clinical reviews over the telephone. Reviews that entire chart to evaluate the appropriateness of admission, continued stay, discharge criteria and identifies high-risk cases.
  • Facilitates discharge planning with treatment team and coordinates continuum of care for the patient with Social Worker. Monitors the effectiveness of patient outcomes.
  • Attends treatment team meetings and serves as a liaison and patient advocate between insurance companies and the treatment team.
  • Notifies and alerts Director of Outpatient Services of potential utilization review problems or denials; assists in the preparation and implementation of the appeals process.
  • Monitors documentation in clinical records and reports problematic areas to appropriate supervisor, Director of Outpatient Services.
  • Assists admissions with screening patients on the pre-hospitalization level to ensure admission criteria are met.
North Spring Behavioral Healthcare, a subsidiary of Universal Health Services, Inc. (UHS), is a Department of Behavioral Health and Developmental Services (DBHDS)-licensed, and Joint Commission approved 87-bed Psychiatric Residential Treatment Facility, and a 40-bed Inpatient Acute Psychiatric Hospital. North Spring is situated on 42 acres of scenic greenlands in historic Leesburg, VA, approximately 25 miles northwest of Washington, D.C. We provide therapeutic programs for adolescents in a safe and secure environment that encourages growth and self-responsibility. Universal Health Services, Inc. (UHS) is one of the nation's largest and most respected healthcare management companies, operating through its subsidiaries acute care hospitals, behavioral health facilities and ambulatory centers nationwide. Founded in 1978, UHS subsidiaries now have more than 83,000 employees. The UHS business strategy is to build or purchase healthcare properties in rapidly growing markets and create a strong franchise based on exceptional service and effective cost control. Our success comes from a responsive management style and a service philosophy based on integrity, competence and compassion.
About Universal Health Services
One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500® corporation, annual revenues during 2025 were $17.4 billion. In 2026, UHS was again recognized as one of Fortune World's Most Admired Companies™ and in 2025, was listed in Forbes ranking of America's Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 101,500 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. For additional information visit www.uhs.com .
EEO Statement
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
Avoid and Report Recruitment Scams
We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information.
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.
If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.
Qualifications
  • Good verbal and written skills; ability to rotate shifts and programs as necessary; ability to maintain confidentiality of patient information.
  • Must consistently exhibit mental and emotional ability to understand and perform the essential functions of the job.
  • Bachelor's degree in related field required.
  • Master's Degree in related field preferred.
  • One to three years of related experience required.
  • Prefer experience with children and adolescents in psychiatric facility or rehabilitation program.
  • Physical Requirements: Must be able to lift and carry up to 50 pounds; 80-90% of the time the incumbent is standing, walking, kneeling, reaching while working with residents. Requires full range of body motion including handling and physical restraint of residents.
  • Ability to perform CPR and First Aid.

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About Universal Health Services

Sourced by ZipRecruiter

Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

King of Prussia, PA, US