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Hca Utilization Review Jobs in Virginia (NOW HIRING)

RN Manager Med Surg

Salem, VA · On-site

$79K - $119K/yr

Manages operating expenses, including the utilization of supplies and equipment. Identifies cost ... HCA Healthcare Co-Founder Be a part of an organization that invests in you! We are reviewing ...

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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:
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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.

$79K - $119K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 8 days ago


Job description

Salary Estimate: $79768.00 - $119662.40 / year
Learn more about the benefits offered for this job.

The estimate displayed represents the typical salary range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range.

Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a RN Manager Med Surg with LewisGale Medical Center you can be a part of an organization that is devoted to giving back!

Job Summary and Qualifications

The Manager ensures high quality, patient-centered care through oversight of the overall daily function and staffing of the unit/department. The Manager monitors and evaluates the provision of nursing care in accordance with established policies/procedures and holds staff accountable for quality and clinical outcomes in support of facility objectives.

Quality:

Helps create a superior clinical identity by operationalizing evidence-based practices to enhance patient safety and quality outcomes. Ensures adherence to standards of care.

Supports efforts to reduce variation in clinical practice and improve efficiency, effectiveness, and cost. Ensures a culture of accountability and transparency in the provision of care.

Supports the achievement of internal/external benchmarks, accreditations, and designations.

Ensures compliance with all policies, procedures, and regulatory standards.

Ensures equipment maintenance is performed regularly and according to regulatory and/or accreditation standards.

Manages admissions and discharge processes to ensure efficient throughput and high quality, patient-centered care.

Facilitates effective interdisciplinary care coordination within and across departments. Ensures staff with appropriate clinical competencies are assigned to meet patient care needs.

Manages nursing practice and unit operations. Monitors and evaluates the provision of nursing care in accordance with established policies/procedures to ensure patient and family needs are assessed and met.

Service:

Provides leadership in attaining and sustaining an unparalleled patient experience. Instills accountability for providing consistent, positive patient interactions that differentiate the organization as a healthcare leader.

Reviews various feedback mechanisms and helps identify opportunities to improve customer/patient satisfaction. Supports the development and implementation of strategies to elevate the patient experience.

Leverages various feedback mechanisms to benchmark performance and identify opportunities to improve patient satisfaction.

Ensures compliance with evidence-based practices that enhance patient experience and customer service.

Collaborates with subject matter experts and other leaders to create an environment of teamwork that supports improved outcomes and service.

Supports a patient-first philosophy and engages in service recovery when necessary.

People:

Leads in a way that inspires commitment to the vision/mission/values of the organization. Implements evidence-based employee engagement practices.

Identifies development opportunities or training needs of individual employees and teams. Provides coaching, feedback, and training to improve performance.

Builds a competitively superior organization through attracting, developing, engaging, and retaining talent. Ensures people with the right skills and motivations are in the right role, at the right time, to meet business needs.

Assumes responsibility for resolving and/or channeling employee grievances, disputes, or concerns according to appropriate procedures.

Growth:

Represents the organization positively within the community; participates in company-supported community/patient events and in-services.

Finance:

Manages staff scheduling. Maintains staffing in accordance with patient care needs and established productivity guidelines.

Manages operating expenses, including the utilization of supplies and equipment. Identifies cost reduction opportunities and implements actions to achieve savings.

Education & Experience:

Associate Degree in Nursing or RN Diploma – Required

Bachelor’s Degree in Nursing – Preferred

3+ years applicable experience – Required

Currently licensed as a registered professional nurse in the state(s) of practice and/or has an active compact license, in accordance with law and regulation. - Required

Benefits

LewisGale Medical Center, 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.

LewisGale Medical Center has provided quality healthcare services since 1909. We give patient's access to trained physicians and advanced technology. Our 500+ bed hospital is one of the leading acute care facilities in the Salem area. We specialize in heart and vascular care—including the latest advanced technology available through our designated Heart Center—as well as orthopedics and spine care, services for mental and behavioral health and cancer care.

At LewisGale Medical Center, our care like family culture extends to our patients, our people and our community. We are committed to each other because when we join together, our patients are cared for in the safest and most compassionate way.

HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.


"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

Be a part of an organization that invests in you! We are reviewing applications for our RN Manager Med Surg opening. Qualified candidates will be contacted for interviews. Submit your application and help us raise the bar in patient care!

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.