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Kaiser Utilization Management Jobs in Virginia (NOW HIRING)

MAPMG

Hospital Rounder- Nocturnist (PRN)

Arlington, VA · On-site

$135/hr

C., exclusively caring for Kaiser Permanente patients. We invite applications for a part-time ... Support patient throughput, utilization management, and quality initiatives by ensuring timely ...

MAPMG

Hospital Rounder- Nocturnist (PRN)

Arlington, VA · On-site

$135/hr

C., exclusively caring for Kaiser Permanente patients. We invite applications for a part-time ... Support patient throughput, utilization management, and quality initiatives by ensuring timely ...

New

MAPMG

Hospital Rounder- Nocturnist

Arlington, VA · On-site

$280K/yr

C., exclusively caring for Kaiser Permanente patients. We invite applications for a Hospital ... Support patient throughput, utilization management, and quality initiatives by ensuring timely ...

New

MAPMG

Hospital Rounder- Nocturnist

Arlington, VA · On-site

$280K/yr

C., exclusively caring for Kaiser Permanente patients. We invite applications for a Hospital ... Support patient throughput, utilization management, and quality initiatives by ensuring timely ...

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Kaiser Utilization Management information

What is the difference between Kaiser Utilization Management vs Kaiser Case Manager?

AspectKaiser Utilization ManagementKaiser Case Manager
Primary RoleReview and authorize healthcare services based on medical necessityCoordinate and manage patient care plans and services
CertificationsTypically requires medical or nursing credentials, possibly certifications in utilization reviewOften requires nursing or social work credentials, with case management certifications
Work EnvironmentUtilization review departments within health plans or hospitalsDirect patient interaction, care coordination teams, healthcare facilities
Industry UsageCommonly employed by health insurance providers like KaiserEmployed in healthcare settings, insurance companies, or integrated health systems

While both roles are integral to healthcare management at Kaiser, Utilization Management focuses on reviewing services for appropriateness, whereas Case Managers actively coordinate patient care and services. Understanding these differences helps clarify career paths and job expectations within Kaiser’s healthcare system.

What is Kaiser Utilization Management?

Kaiser Utilization Management refers to the process within Kaiser Permanente that evaluates the necessity, appropriateness, and efficiency of healthcare services provided to members. Utilization management professionals review medical cases to ensure that treatments and procedures are medically necessary and align with established guidelines. Their goal is to optimize healthcare outcomes while controlling costs and preventing unnecessary services, ensuring members receive the right care at the right time.

How does a Kaiser Utilization Management professional typically collaborate with healthcare providers to ensure appropriate patient care?

Kaiser Utilization Management professionals work closely with physicians, nurses, and other healthcare team members to review patient cases and ensure that treatments and services are medically necessary and align with organizational guidelines. This collaboration often involves case discussions, care planning meetings, and providing recommendations for alternative care options when appropriate. Open communication and a collaborative approach help ensure patients receive high-quality care while also managing resources efficiently. Professionals in this role regularly interact with both clinical and administrative staff to resolve issues and support optimal patient outcomes.

What are the key skills and qualifications needed to thrive as a Kaiser Utilization Management professional, and why are they important?

To thrive in Kaiser Utilization Management, you need a solid background in clinical healthcare (often as an RN or other licensed clinician), understanding of medical necessity criteria, and experience with healthcare regulations. Familiarity with utilization review software, electronic health records (EHRs), and knowledge of guidelines such as Milliman or InterQual are typically required. Excellent communication, critical thinking, and organizational skills set standout professionals apart in this role. These competencies ensure effective resource management, regulatory compliance, and quality patient care within the healthcare system.
What are popular job titles related to Kaiser Utilization Management jobs in Virginia? For Kaiser Utilization Management jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Kaiser Utilization Management jobs in Virginia look for? The top searched job categories for Kaiser Utilization Management jobs in Virginia are:
Kaiser Utilization Management jobs near you
Infographic showing various Kaiser Utilization Management job openings in Virginia as of July 2026, with employment types broken down into 50% Full Time, and 50% Part Time. Highlights an 100% In-person job distribution.

Hospital Rounder- Nocturnist (PRN)

Mid-Atlantic Permanente Medical Group PC

Arlington, VA

$135/hr

Part-time

Medical, Dental, Life, Retirement, PTO

Posted 4 days ago

Job description

The Mid-Atlantic Permanente Medical Group (MAPMG) is a leading group of over 1,800 physicians in Maryland, Virginia, and Washington, D.C., exclusively caring for Kaiser Permanente patients. We invite applications for a part-time Hospital Rounder- Nocturnist at Virginia Hospital Center.

Unlike other U.S. health systems, MAPMG is built and led by physicians who earn competitive salaries, without income based on providing individual services. Our medical group comprises board-certified physicians across 60+ specialties. MAPMG physicians use a comprehensive electronic health record (EHR) to coordinate care. Our focus is on long-term health, prevention, diagnosing, and treating diseases effectively. MAPMG researchers and staff support innovative ideas, ensuring quality care, educational programming, and advancing best practices through research.  

What You Can Expect:

  • Provide overnight inpatient medical care, including admissions, Consults, cross-coverage, Rapid clinical assessment, and management of acutely ill hospitalized patients.
  • Evaluate the appropriateness of hospitalization for newly admitted patients and collaborate with the Emergency Department, consultants, and care management to ensure patients receive care in the most appropriate setting, including consideration of Advanced Care at Home (ACAH) and other alternative care pathways when appropriate.
  • Coordinate overnight specialty consultations, respond to urgent clinical issues, and facilitate safe transitions of care through comprehensive handoffs to the daytime Hospital Medicine team.
  • Support patient throughput, utilization management, and quality initiatives by ensuring timely admissions, appropriate level-of-care decisions, and efficient care coordination.
  • Practice independently overnight while working collaboratively with nursing, consultants, and the broader Hospital Medicine team to provide safe, high-quality, patient-centered care for inpatient patients as well as providing Cross coverage for some of our core SNFs.
  • You will have access to integrated outpatient record in the EMR to facilitate admissions
  • No procedures required
  • Codes and Rapid response: Only attend to provide medical support if it is Kaiser patient: There is in-house Code Blue and Rapid Response Teams at core hospitals
  • There is 24/7 in-house intensivist physician at core hospitals
  • Some shifts covering KP observation unit (extended monitoring unit) at advanced urgent care centers
  • 7 shifts per each 14-day block; shifts 7p to 7a

Minimum Requirements:

  • MD or DO
  • Board Certified or Eligible in Internal Medicine
  • Currently licensed or able to obtain licenses in the District of Columbia, Maryland, and Virginia

MAPMG Physicians:

  • Practice patient-centered, culturally competent medical care
  • Communicate thoughtfully (listen, educate, advocate)
  • Lead with integrity
  • Value teamwork
  • Are transparent and honest
  • Go “above and beyond” for their patients

We Provide You:

  • Competitive compensation
  • Pathway for physicians to become shareholders of MAPMG
  • Comprehensive benefits including 100% employer-funded medical and dental insurance premiums, a pension plan and 401(k), life insurance, and paid leave
  • Complete professional liability coverage provided at no cost, 100% reimbursement for obtaining and maintaining board certification, continuing medical education reimbursement, and in-house CME opportunities
  • A concierge service that works directly with you to apply for all required state, CDS, and DEA licenses

The starting hourly rate for this position is $135.00 which considers an applicant’s skills and qualifications, certain degrees and certifications, training, market data, and other relevant factors. 

MAPMG continuously works to identify and mitigate healthcare inequities, and that starts with providing an inclusive, supportive environment for our physicians. We encourage applicants of any race, color, religion, sex, sexual orientation, gender identity, or national origin who commit to practicing culturally competent healthcare.

Apply