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Manager Utilization Management Jobs in Virginia (NOW HIRING)

Charter Global

Utilization Management

Reston, VA · Remote

Utilization Management Location: Reston, VA (Remote) Duration: 3+ Months Contract PURPOSE: Supports the Utilization Management clinical teams by assisting with non-clinical administrative tasks and ...

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UHS

Director of Utilization Management

Danville, VA · On-site

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 ...

Summit BHC

Utilization Specialist

Williamsburg, VA · On-site

Coordinates, performs, and monitors all utilization review/management activities of the hospital to continuously improve the collection, reimbursement, coordination, and presentation of utilization ...

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All JobsManager Utilization Management JobsManager Utilization Management Jobs in Virginia

Manager Utilization Management information

See Virginia salary details

$38.7K

$90.2K

$166.1K

How much do manager utilization management jobs pay per year?

As of Jun 12, 2026, the average yearly pay for manager utilization management in Virginia is $90,231.00, according to ZipRecruiter salary data. Most workers in this role earn between $59,000.00 and $108,600.00 per year, depending on experience, location, and employer.

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

To thrive as a Manager Utilization Management, you need a thorough understanding of healthcare regulations, utilization review processes, and case management, often supported by a clinical degree (such as RN) and relevant experience. Familiarity with utilization management software, claims processing systems, and potentially certifications like CCM (Certified Case Manager) or ACM (Accredited Case Manager) is important. Strong leadership, analytical thinking, and effective communication help you guide teams and collaborate with providers and payers. These skills ensure efficient resource use, compliance, and quality patient care within managed care organizations.

What is the difference between Manager Utilization Management vs Utilization Review Nurse?

AspectManager Utilization ManagementUtilization Review Nurse
CredentialsRN, often with management or utilization review certificationsRN, with certifications in utilization review or case management
Work EnvironmentSupervises teams, manages policies, oversees utilization review processesPerforms patient chart reviews, assesses medical necessity, collaborates with providers
Employer & IndustryHospitals, insurance companies, healthcare organizationsHospitals, insurance companies, healthcare organizations
Search & Comparison IntentYesYes

While both roles focus on utilization review, the Manager Utilization Management oversees teams and policies, ensuring efficient resource use, whereas the Utilization Review Nurse conducts patient-specific reviews to determine medical necessity. The manager role involves leadership and strategic planning, while the nurse role is more clinical and review-focused.

What are some common challenges faced by a Manager in Utilization Management, and how can they effectively address them?

Managers in Utilization Management often encounter challenges such as balancing quality patient care with cost containment, navigating evolving healthcare regulations, and managing diverse teams. To effectively address these issues, successful managers develop strong communication skills, stay updated on industry standards, and foster collaboration between clinical and administrative staff. Implementing robust training programs and utilizing data-driven decision-making can also help ensure compliance and improve overall team performance.

What does a Manager of Utilization Management do?

A Manager of Utilization Management oversees the process of evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. They lead a team that reviews medical claims and care plans to ensure compliance with clinical guidelines and regulatory requirements. Their role often involves collaborating with physicians, nurses, insurance companies, and other stakeholders to optimize patient outcomes while managing healthcare costs. Additionally, they are responsible for implementing policies, training staff, and ensuring that utilization management activities align with organizational goals.
What are the most commonly searched types of Utilization Management jobs in Virginia? The most popular types of Utilization Management jobs in Virginia are:
What are popular job titles related to Manager Utilization Management jobs in Virginia? For Manager Utilization Management jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Manager Utilization Management jobs in Virginia look for? The top searched job categories for Manager Utilization Management jobs in Virginia are:
What cities in Virginia are hiring for Manager Utilization Management jobs? Cities in Virginia with the most Manager Utilization Management job openings:
Manager Utilization Management jobs near you
Utilization Management

Utilization Management

Charter Global

Reston, VA • Remote

Other

This job post has expired 1 day ago. Applications are no longer accepted.

Job description

Job Title: Utilization Management

Location: Reston, VA (Remote)

Duration: 3+ Months Contract


PURPOSE:

Supports the Utilization Management clinical teams by assisting with non-clinical administrative tasks and responsibilities related to pre-service, utilization review, care coordination and quality of care.

3 years’ experience in health care/managed care setting or previous work experience within division

2 years of CPT and ICD-10 coding.

Previous authorization experience

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