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Manager Utilization Management Jobs in Washington

Inova

Registered Nurse (RN) Case Manager

Fairfax, VA · On-site

Uses utilization management techniques to determine the medical necessity, appropriateness and efficiency of the use of healthcare services, procedures and facilities. Responsible for the timely ...

Inova

Registered Nurse (RN) Case Manager

Fairfax, VA · On-site

$86K - $140K/yr

Uses utilization management techniques to determine the medical necessity, appropriateness and efficiency of the use of healthcare services, procedures and facilities. Responsible for the timely ...

Evolent

Radiology Physician

Arlington, VA

$368K - $460K/yr

As a FMD, Radiology you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients lives, in a non-clinical environment. You can enjoy ...

Inova

Director, Case Management

Leesburg, VA · On-site

$130K - $211K/yr

Leads all utilization review, social work and discharge planning activities within assigned operating unit. * Oversees the day to day operation of all Case Management related activities to include ...

Evolent

Internal Medicine Physician

Arlington, VA

As a FMD, Radiology, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients lives, in a non-clinical environment. You can ...

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All JobsUtilization Management JobsManager Utilization Management JobsManager Utilization Management Jobs in Washington

Manager Utilization Management information

See Washington salary details

$44.2K

$103.1K

$189.7K

How much do manager utilization management jobs pay per year?

As of Jul 16, 2026, the average yearly pay for manager utilization management in Washington is $103,079.00, according to ZipRecruiter salary data. Most workers in this role earn between $67,400.00 and $124,000.00 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 Washington? The most popular types of Utilization Management jobs in Washington are:
What are popular job titles related to Manager Utilization Management jobs in Washington? For Manager Utilization Management jobs in Washington, the most frequently searched job titles are:
What job categories do people searching Manager Utilization Management jobs in Washington look for? The top searched job categories for Manager Utilization Management jobs in Washington are:
What cities in Washington are hiring for Manager Utilization Management jobs? Cities in Washington with the most Manager Utilization Management job openings:
Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in Washington as of July 2026, with employment types broken down into 1% As Needed, 79% Full Time, 17% Part Time, 1% Temporary, and 2% Contract. Highlights an 85% Physical, 5% Hybrid, and 10% Remote job distribution, with an average salary of $103,079 per year, or $49.6 per hour.
Hospitalist Medical Director | Management Bonus Incentive!

Hospitalist Medical Director | Management Bonus Incentive!

Sound Physicians

Dulles, VA

$320K/yr

Full-time

Posted 5 days ago

Job description

Bring Better to the Bedside as a Hospitalist Medical Director in Washington, DC

We believe in bringing “better” to our local community here in Washington, DC —better care, better collaboration, and a deep commitment to the people we serve. We'd love to talk if you’re looking for a role that supports your professional growth and connection to a vibrant city.

Local Team Collaboration:

  • We’re a welcoming team of 6 physicians and 2 advanced practitioners who work closely with other hospital staff and departments at Cedar Hill Regional Medical Center to deliver the best possible quality of care to our patients.
  •  Our dedicated team consists of two physicians and one APP during the day as well as one physician Nocturnist at night.
  • We are an integral part of our hospital community and a valued strategic partner, maintaining great relationships with hospital leadership.
  • We focus on utilization management (UM), compliance, and clinical documentation improvement (CDI) to support hospital performance.
  • Our dedicated site coordinator will help maintain a healthy work-life balance.
  • Sound's team also covers the Emergency Department at Cedar Hill RMC.

Qualifications:

  • A Medical Degree (MD or DO) from an accredited institution.
  • Board-certified in internal medicine or family medicine.
  • Prior Hospitalist Medical Director or Leadership experience required.
  • Authorized to work in the United States.

Scheduling:

  • This Medical Director position is 100% clinical.
  • 7-days-on, 7-days-off rotation.
  • Hours are 7:00 AM to 7:00 PM.

Key Responsibilities:

  • Collaborate with Sound Physician leaders who work to enhance hospital services as the Medical Director of hospitalist services.
  • Lead efforts in utilization management, compliance, and clinical documentation improvement at Piedmont Macon Northside.
  • Collaborate with hospital administration to identify and implement performance improvement initiatives, such as length of stay, readmissions, and regulatory compliance.
  • As a day hospitalist, you will experience an average census of 16 patients with 1-2 admissions per day.
  • Organize and participate in monthly team meetings to review performance, address outstanding practice matters, and support our network of physicians.
  • We work in Oracle Health (formerly Cerner) with access to our internal informatics platform.

Living and Working in Washington, DC:

Washington, DC, the U.S. capital, is a compact city on the Potomac River, bordering the states of Maryland and Virginia. DC is the epicenter of the federal government and features world-class museums, historic neighborhoods, and iconic national monuments. Experience local DC culture, dining, and boutique shopping in historic areas like Georgetown, the vibrant riverfront at The Wharf, or the artsy corridors of Adams Morgan. Despite being a major city, D.C. has immense green spaces like Rock Creek Park, the National Arboretum, and the National Mall for running, cycling, and picnics. With Cedar Hill RMC located on the Green Line, you have excellent commuting flexibility.

Rewards and Compensation:

  • The base salary for the Medical Director position is $320,000/year, with opportunities for performance-based and management bonuses. Additional compensation is paid for shifts worked above the full-time commitment.


Jill Albach, Associate Sr. Director, Clinical Recruitment | jalbach@soundphysicians.com | (301) 532-2828

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About Sound Physicians

Sourced by ZipRecruiter

Sound Physicians is a leading physician partner to hospitals, health plans, physician groups, and post-acute providers seeking to transform outcomes for acute episodes of care. For 20 years our high-performing and affordable care models have combined physician leadership, clinical process, technology and analytics to consistently improve clinical and financial performance. We are pioneers in value, working together with our partners and community providers to bridge gaps in care, from hospital to home.

Industry

Health care and social assistance

Company size

1,001 - 5,000 Employees

Headquarters location

Tacoma, WA, US

Year founded

2001

Social media

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