ZipRecruiter

Log In

1

Insurance Utilization Review Jobs in Virginia (NOW HIRING)

Dane Street, LLC

Board-Certified Pulmonologist

Richmond, VA · On-site

$296K - $395K/yr

... peer review services, trusted by insurance carriers and organizations across the country for ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...

Dane Street, LLC

Board-Certified Pulmonologist

Richmond, VA · On-site

$296K - $395K/yr

... peer review services, trusted by insurance carriers and organizations across the country for ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...

Envision Health Inc

LPC/LCSW

Hampton, VA · On-site

Participate in chart audits, peer review, and utilization review processes. Collaboration & Care ... Eligibility for credentialing with Medicaid and commercial insurers preferred. Experience * Minimum ...

VHS Hospice

RN Case Manager

Newport News, VA

$70K - $95K/yr

Previous case management or utilization review experience preferred. * Direct patient care ... Shift differentials * Company-sponsored life insurance * Employee assistance program (EAP ...

VHS Hospice

RN Case Manager

Newport News, VA

$70K - $95K/yr

Previous case management or utilization review experience preferred. * Direct patient care ... Shift differentials * Company-sponsored life insurance * Employee assistance program (EAP ...

next page

Showing results 1-20

All JobsInsurance Utilization Review JobsInsurance Utilization Review Jobs in Virginia

Insurance Utilization Review information

See Virginia salary details

$21

$41

$68

How much do insurance utilization review jobs pay per hour?

As of Jul 15, 2026, the average hourly pay for insurance 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 are the most common challenges faced by Insurance Utilization Review professionals?

One common challenge in Insurance Utilization Review is balancing the need for cost-effective care with the clinical needs of patients, which often requires careful analysis and decision-making. Professionals in this role frequently navigate complex medical records, strict policy guidelines, and collaborate with healthcare providers who may advocate strongly for particular treatments. Managing challenging conversations while maintaining professionalism and ensuring timely determinations are also a regular part of the role. Developing expertise in these areas can make the job both demanding and rewarding, while building a strong foundation for career growth within healthcare administration.

What are the key skills and qualifications needed to thrive in the Insurance Utilization Review position, and why are they important?

To thrive in Insurance Utilization Review, you generally need a strong background in healthcare or nursing, an understanding of medical terminology, and analytical thinking skills, often supported by an RN license or relevant clinical experience. Familiarity with utilization management software, coding systems like ICD-10, and knowledge of regulatory requirements (such as Medicare or Medicaid) are important. Strong communication, attention to detail, and problem-solving abilities help professionals excel when interacting with providers and insurers. These skills are essential to ensure appropriate care is authorized while maintaining regulatory compliance and cost-effectiveness.

What is an Insurance Utilization Review job?

An Insurance Utilization Review job involves evaluating medical treatments and services to determine if they are necessary, appropriate, and covered by a patient's insurance plan. Professionals in this role review medical records, treatment plans, and insurance policies to ensure compliance with guidelines and cost-effectiveness. They work closely with healthcare providers, insurance companies, and patients to facilitate approvals or appeals. The goal is to balance quality patient care with cost containment in the healthcare system.

What are the most commonly searched types of Insurance Utilization Review jobs in Virginia? The most popular types of Insurance Utilization Review jobs in Virginia are:
What are popular job titles related to Insurance Utilization Review jobs in Virginia? For Insurance Utilization Review jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Insurance Utilization Review jobs in Virginia look for? The top searched job categories for Insurance Utilization Review jobs in Virginia are:
What cities in Virginia are hiring for Insurance Utilization Review jobs? Cities in Virginia with the most Insurance Utilization Review job openings:
Insurance Utilization Review jobs near you
Infographic showing various Insurance Utilization Review job openings in Virginia as of July 2026, with employment types broken down into 87% Full Time, 5% Part Time, 5% Contract, and 3% Nights. Highlights an 100% In-person job distribution, with an average salary of $87,192 per year, or $41.9 per hour.
Board-Certified Pulmonologist

Board-Certified Pulmonologist

Dane Street, LLC

Richmond, VA • On-site

$296K - $395K/yr

Full-time

Re-posted 13 days ago

Job description

Dane Street is expanding our physician panel! We are seeking a skilled and board-certified Pulmonologist in Richmond, VA, to join our team for Independent Medical Examinations (IMEs). This role offers flexible scheduling, allowing you to select or decline assignments based on your availability. Our physician panel is comprised of independent contract reviewers (1099) compensated on a per-case basis.

  • Dane Street is a national leader in Independent Medical Examinations (IMEs) and peer review services, trusted by insurance carriers and organizations across the country for objective, high-quality medical evaluations.

Key Responsibilities:

  • Thorough review of Medical Records
  • Perform in-person evaluations of patients with Pulmonology issues
  • Respond to clinical queries to support claims management
  • Deliver detailed IME reports within an expected turnaround time of 5 days

Requirements

Qualifications:

  • Board-certification required.
  • Previous experience in performing IMEs is preferred.
  • Strong analytical skills and excellent communication abilities are a plus
  • If you are a dedicated Pulmonologist looking for a flexible opportunity to apply your expertise in an IME capacity, we encourage you to apply.

Benefits

Benefits

  • Robust opportunity for supplemental income
  • Schedule flexibility and predictable work hours-conduct exams and reviews based on your schedule availability
  • No doctor/patient relationship is established, and no treatment is provided. These are advisory-only opinions.
  • Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise
  • Expanded credentials as an expert in Independent Medical Exams
  • Fully prepped cases, streamlined case flow, transcription services at no cost, and a user-friendly work portal