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Hca Utilization Review Jobs in Virginia (NOW HIRING)

HCA Healthcare Research Institute is the multispecialty clinical research arm of HCA Healthcare. ... Reviews the study design and inclusion/exclusion criteria with physician and patient * Ensures the ...

New

Research Nurse

Richmond, VA · On-site

$69K - $103K/yr

HCA Healthcare Research Institute is the multispecialty clinical research arm of HCA Healthcare. ... Reviews the study design and inclusion/exclusion criteria with physician and patient * Ensures the ...

New

Manager Clinical Pharmacy

Henrico, VA · On-site

$130K - $196K/yr

Directs, coordinates, and participates in the design, collection, and reporting of drug utilization ... HCA Healthcare Co-Founder Be a part of an organization that invests in you! We are reviewing ...

Showing results 21-40

Hca Utilization Review information

What is an HCA Utilization Review?

An HCA Utilization Review job involves evaluating medical services to ensure they are necessary, cost-effective, and meet quality standards. Professionals in this role review patient records, coordinate with healthcare providers, and ensure treatments align with insurance guidelines and hospital policies. They play a key role in optimizing resource utilization, preventing unnecessary procedures, and ensuring compliance with regulations. Strong analytical skills and knowledge of medical terminology are essential for success in this position.

What are the key skills and qualifications needed for an HCA Utilization Review?

To thrive as a HCA Utilization Review professional, you need a solid foundation in medical terminology, clinical assessment, and insurance guidelines, often supported by a healthcare-related degree or nursing license. Familiarity with utilization review software, electronic health records (EHR) systems, and certifications like CCM (Certified Case Manager) are highly beneficial. Excellent analytical thinking, attention to detail, and strong communication skills help you effectively evaluate patient records and collaborate with providers. These competencies are key to ensuring appropriate care utilization, supporting cost-effective treatment decisions, and maintaining regulatory compliance.

What does an HCA Utilization Review do?

In HCA Utilization Review, your day usually involves reviewing patient medical records, assessing the necessity and appropriateness of proposed treatments, and communicating decisions to physicians and case managers. You may also participate in interdisciplinary meetings, liaise with insurance providers for authorization, and document your findings in healthcare management systems. The role is collaborative, requiring you to interact with diverse medical and administrative teams to align patient care with policy guidelines. This blend of independent evaluation and team collaboration makes each day varied and impactful for patient outcomes.

What are the most commonly searched types of Hca Utilization Review jobs in Virginia? The most popular types of Hca Utilization Review jobs in Virginia are:
What are popular job titles related to Hca Utilization Review jobs in Virginia? For Hca Utilization Review jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Hca Utilization Review jobs in Virginia look for? The top searched job categories for Hca Utilization Review jobs in Virginia are:
What cities in Virginia are hiring for Hca Utilization Review jobs? Cities in Virginia with the most Hca Utilization Review job openings:
Infographic showing various Hca Utilization Review job openings in Virginia as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 17% Part Time, and 4% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution.

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Galen College Of Nursing rating

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Company rating: 6.8 out of 10

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Job description

Research Nurse

Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. HCA Healthcare Research Institute is the multispecialty clinical research arm of HCA Healthcare. Our expert physicians work with trusted pharmaceutical and biotechnology partners to unlock insights from real-world data and conduct clinical studies leading to breakthroughs in science, medicine and care for all people. Today's research paves the way for tomorrow's breakthroughs. Consider joining our HCA Healthcare Research Institute today!

The Research Nurse is responsible for coordinating multiple research protocols and serving as a liaison with local investigators, clinical staff, and research personnel. Under direct supervision, this individual will mature in their understanding of research operations and regulations in order to achieve a strong fundamental understanding of human subject research. This role is hospital based.

  • Supports enrolling patients onto clinical trials through recruitment, screening, enrollment and follow up of eligible subjects according to protocol requirements
  • Responsible for working with the principal investigator to meet or exceed study enrollment.
  • Reviews the study design and inclusion/exclusion criteria with physician and patient
  • Ensures the protection of study patients by verifying informed consent procedures and adhering to protocol requirements/compliance
  • Ensures the integrity of the data submitted on Case Report Forms or other data collection tools by careful source document review; monitors data for missing or implausible data
  • Ensures that adequate and accurate records are maintained for inspecting
  • Creates study specific tools for source documentation when not provided by sponsor
  • Collects, completes, and enters data into study specific case report forms or electronic data capture systems
  • Generates and tracks drug shipments, device shipments, and supplies as needed
  • Reports and follows up on serious adverse events as necessary
  • Implements study-specific communications
  • Ensures timely adherence to protocol requirements
  • Responsible for completion of all required documentation according to site works guidelines
  • Ensures timely and accurate data completion
  • Maintains accurate and complete records including regulatory documents when applicable, signed informed consent forms, source documentation, drug dispensing logs, device utilization logs, subject logs and study-related communications
  • Tracks and reports adverse events, serious adverse events, protocol waivers, deviations, and violations
  • Communicates all protocol-related issues to appropriate study colleagues or manager
  • Attends study specific on site meetings, investigator meetings, conference calls and monthly CRC meetings as required or asked to do so
  • Apprises principal investigator, Research Operations Director and Regional Site Manager of all study specific medical issues for guidance
  • Assists sponsor and US FDA audit teams
  • Reviews and responds to any monitoring and auditing findings and escalates issues defined by Regional Site Manager
  • Maintains patient confidentiality according to ethical and legal requirements
  • Assists in providing coverage for satellite clinic sites as necessary
  • Responsible for coverage after hours and on weekends as necessary

What qualifications you will need:

  • Bachelor's Degree required
  • Active RN License required
  • Knowledge of federal regulations, good clinical practices (GCP)
  • Knowledge of medical and research terminology
  • Computer skills including use of clinical trial database, electronic data capture, and MS Word or Excel
  • Excellent Verbal and written communication skills
  • Excellent interpersonal skills
  • The ability to communicate and work effectively with a diverse team of professionals
  • Organizational and prioritizing capabilities
  • The ability to work independently in a fast pace environment with minimal supervision at off-site facilities

Chippenham Hospital, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

  • Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
  • Wellbeing support, including free counseling and referral services
  • Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
  • Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
  • Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
  • Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

"There is so much good to do in the world and so many different ways to do it." - Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder

If you find this opportunity compelling, we encourage you to apply for our Research Nurse opening. We promptly review all applications. Highly qualified candidates will be directly contacted by a member of our team. We are interviewing - apply today!

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.


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