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Manager Utilization Management Jobs in Virginia (NOW HIRING)

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 ...

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

The Utilization Assistant provides support to all utilization review/management activities of the hospital to continuously improve the collection, reimbursement, coordination, and presentation of ...

Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Strong desktop skills including Word, Excel, PowerPoint * Work Experience/Direct Knowledge of ...

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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 13, 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 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:
Director of Utilization Management

Director of Utilization Management

UHS

Danville, VA • On-site

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 28 days ago


Universal Health Services rating

6.7

Company rating: 6.7 out of 10

Based on 248 frontline employees who took The Breakroom Quiz

525th of 872 rated healthcare providers


Job description

Responsibilities
The Hughes Center is a highly-structured psychiatric residential treatment facility for youth ages 10 to 22 with neurodevelopmental disorders. The Hughes Center also provides private, community-based educational services. We provide both individualized and holistic care for adolescents and young adults with intellectual and developmental disabilities in a nurturing, family-friendly environment. We utilize a multidisciplinary team approach to provide comprehensive evaluations and evidence-based treatment (and educational) interventions with the intent to increase each youth's level of functional independence. Our team also works diligently to address or manage medical conditions and challenging behaviors that are often associated with individuals who are diagnosed with neurodevelopmental disorders. We challenge our residents to adapt to and apply learned skills within new environments and situations, and to maintain functional use of these skills when they return to their homes or other community-based settings.
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 admitted, follows the chart checking that documentation reflects and meets admission, continued stay, and discharge criteria. This position interacts and communicates with clinical staff, the Business Office, Admissions, Medical Records, third party reviewers and hospital administration to help patients receive the proper hospital care that they need.
Benefit Highlights:
  • Challenging and rewarding work environment
  • Competitive Compensation
  • Tuition Reimbursement Program
  • Excellent Medical, Dental, Vision and Prescription Drug Plan
  • 401(K) with company match and discounted stock plan
  • Generous Paid Time Off
  • Career development opportunities within UHS and its 300+ Subsidiaries

About Universal Health Services
One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (NYSE: UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 300 corporation, annual revenues were $15.8 billion in 2024. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 99,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com
Qualifications
Bachelor's degree in human services; Master's degree in human services preferred. Three to five years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, or LCP in Virginia required.
EEO Statement
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
Notice
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.

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About Universal Health Services

Sourced by ZipRecruiter

Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

King of Prussia, PA, US