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Director Of Utilization Review Jobs in Virginia (NOW HIRING)

Visit us online: www.thehughescenter.com The Director of Utilization Management assists admissions ... Three to five years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, ...

Visit us online: www.thehughescenter.com The Director of Utilization Management assists admissions ... Three to five years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, ...

Visit us online: www.thehughescenter.com The Director of Utilization Management assists admissions ... Three to five years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, ...

Visit us online: www.thehughescenter.com The Director of Utilization Management assists admissions ... Three to five years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, ...

Visit us online: www.thehughescenter.com The Director of Utilization Management assists admissions ... Three to five years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, ...

Visit us online: www.thehughescenter.com The Director of Utilization Management assists admissions ... Three to five years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, ...

The Utilization Review Nurse is responsible for utilization management services within the scope of ... Conducts primary functions of prior authorization, retrospective review, medical director referrals ...

The Utilization Review Nurse is responsible for utilization management services within the scope of ... Conducts primary functions of prior authorization, retrospective review, medical director referrals ...

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... minimum of three (3) years direct clinical experience in a psychiatric or mental health setting ... · Assist in preparing Utilization Review Reports as necessary. · Coordinates and makes ...

... minimum of three (3) years direct clinical experience in a psychiatric or mental health setting ... · Assist in preparing Utilization Review Reports as necessary. · Coordinates and makes ...

... minimum of three (3) years direct clinical experience in a psychiatric or mental health setting ... · Assist in preparing Utilization Review Reports as necessary. · Coordinates and makes ...

... Assist in preparing Utilization Review Reports as necessary. • Coordinates and makes ... minimum of three (3) years direct clinical experience in a psychiatric or mental health setting.

... minimum of three (3) years direct clinical experience in a psychiatric or mental health setting ... · Assist in preparing Utilization Review Reports as necessary. · Coordinates and makes ...

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Director Of Utilization Review information

See Virginia salary details

$21

$41

$68

How much do director of utilization review jobs pay per hour?

As of Sep 4, 2026, the average hourly pay for director of utilization review in Virginia is $41.92, according to ZipRecruiter salary data. Most workers in this role earn between $33.12 and $48.12 per hour, depending on experience, location, and employer.

What is a director of utilization review?

A Director of Utilization Review is a healthcare management professional responsible for overseeing the utilization review process in hospitals or healthcare organizations. This role ensures that medical services provided to patients are necessary, appropriate, and efficient, while also complying with regulatory and insurance requirements. The Director supervises a team, manages policies, analyzes data, and collaborates with medical staff to optimize patient care and resource use. They play a key role in balancing quality care with cost-effective practices.

What are the key skills and qualifications needed to thrive as a director of utilization review?

To thrive as a Director of Utilization Review, you need strong clinical expertise, analytical skills, and an advanced degree in nursing or a related healthcare field—often with RN licensure and significant case management experience. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of regulatory standards like CMS and Joint Commission are typically required. Leadership, effective communication, and critical thinking are vital soft skills for overseeing teams and collaborating with healthcare providers. These skills and qualifications ensure efficient resource use, regulatory compliance, and optimal patient care outcomes.

What are some common challenges faced by a director of utilization review, and how can they be addressed?

Directors of Utilization Review often encounter challenges such as balancing regulatory compliance with operational efficiency, managing diverse teams, and ensuring consistent application of utilization management criteria. Addressing these challenges typically involves staying up to date with changing healthcare regulations, fostering open communication within multidisciplinary teams, and implementing robust training programs. Leveraging data analytics tools can also help streamline review processes and improve decision-making, which supports both patient care quality and organizational goals.

What is the difference between Director Of Utilization Review vs Utilization Review Nurse?

AspectDirector Of Utilization ReviewUtilization Review Nurse
CredentialsTypically requires a registered nurse (RN) license, often with management experienceRequires an RN license and clinical experience
Work EnvironmentOversees utilization review teams, manages policies, and collaborates with healthcare providersPerforms clinical reviews, assesses patient records, and makes utilization decisions
Employer & IndustryHospitals, insurance companies, healthcare organizationsHospitals, clinics, insurance companies

The main difference is that the Director Of Utilization Review manages teams and policies, focusing on strategic oversight, while the Utilization Review Nurse conducts clinical assessments and reviews patient cases. Both roles require nursing credentials but differ in scope and responsibilities.

Is a director of utilization review a stressful job?

A director of utilization review often faces stress due to managing complex case evaluations, ensuring compliance with healthcare regulations, and meeting organizational goals. The role requires strong decision-making skills, attention to detail, and the ability to handle high workloads, which can contribute to job-related stress.

What degree do I need for a Director Of Utilization Review?

A Director of Utilization Review typically needs a bachelor's degree in healthcare administration, nursing, or a related field, with many employers preferring a master's degree such as an MBA or a master's in healthcare management. Relevant experience in healthcare, strong knowledge of insurance and medical policies, and professional certifications like Certified Professional in Healthcare Quality (CPHQ) can also be important. Leadership skills and familiarity with utilization review tools are essential for this role.

What cities in Virginia are hiring for Director Of Utilization Review jobs?

Cities in Virginia with the most Director Of Utilization Review job openings:

Infographic showing various Director Of Utilization Review job openings in Virginia as of August 2026, with employment types broken down into 50% Full Time, and 50% Part Time. Highlights an 100% In-person job distribution, with an average salary of $87,192 per year, or $41.9 per hour.

Director of Utilization Management

UHS

Danville, VA • On-site

$79K - $95K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 22 days ago


Key responsibilities

  • Assist admissions in screening patients at the pre-hospital level to ensure admission criteria are met.

  • Follow the chart checking process to ensure documentation reflects and meets admission, continued stay, and discharge criteria.

  • Communicate and interact with clinical staff, the Business Office, Admissions, Medical Records, third-party reviewers, and hospital administration to coordinate patient care.


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 898 rated healthcare providers


Job description

Responsibilities
The Hughes Center is a highly-structured psychiatric residential treatment facility for youth ages 10 to 22 with neurodevelopmental disorders. The Hughes Center also provides private, community-based educational services. We provide both individualized and holistic care for adolescents and young adults with intellectual and developmental disabilities in a nurturing, family-friendly environment. We utilize a multidisciplinary team approach to provide comprehensive evaluations and evidence-based treatment (and educational) interventions with the intent to increase each youth's level of functional independence. Our team also works diligently to address or manage medical conditions and challenging behaviors that are often associated with individuals who are diagnosed with neurodevelopmental disorders. We challenge our residents to adapt to and apply learned skills within new environments and situations, and to maintain functional use of these skills when they return to their homes or other community-based settings.
Visit us online: www.thehughescenter.com
The Director of Utilization Management 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. This position interacts and communicates with clinical staff, the Business Office, Admissions, Medical Records, third party reviewers and hospital administration to help patients receive the proper hospital care that they need.
Benefit Highlights:
  • Challenging and rewarding work environment
  • Competitive Compensation
  • Tuition Reimbursement Program
  • Excellent Medical, Dental, Vision and Prescription Drug Plan
  • 401(K) with company match and discounted stock plan
  • Generous Paid Time Off
  • Career development opportunities within UHS and its 300+ Subsidiaries

About Universal Health Services
One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (NYSE: UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 300 corporation, annual revenues were $15.8 billion in 2024. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 99,000 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 all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com
Qualifications
Bachelor's degree in human services; Master's degree in human services preferred. Three to five years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, or LCP in Virginia required.
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.
We believe that diversity and inclusion among our teammates is critical to our success.
Notice
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.

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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