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Part Time Utilization Management Jobs in Virginia

Inova

Registered Nurse (RN) Case Manager

Fairfax, VA · On-site

This role will be Part-Time Day shift, 24 hours per week, Monday - Friday day shift schedule with ... Uses utilization management techniques to determine the medical necessity, appropriateness and ...

Inova

Registered Nurse (RN) Case Manager 1

Leesburg, VA · On-site

This role will be Part-Time Weekends (Every Saturday & Sunday), 2- 10 hour shifts per week Inova is ... Uses utilization management techniques to determine the medical necessity, appropriateness and ...

Inova

Registered Nurse (RN) Case Manager 1

Leesburg, VA · On-site

This role will be Part-Time Weekends (Every Saturday & Sunday), 2- 10 hour shifts per week Inova is ... Uses utilization management techniques to determine the medical necessity, appropriateness and ...

Inova

Registered Nurse (RN) Case Manager 1

Leesburg, VA · On-site

$86K - $140K/yr

This role will be Part-Time Weekends (Every Saturday & Sunday), 2- 10 hour shifts per week Inova is ... Uses utilization management techniques to determine the medical necessity, appropriateness and ...

MAPMG

Hospital Rounder- Nocturnist (PRN)

Arlington, VA · On-site

$135/hr

We invite applications for a part-time Hospital Rounder- Nocturnist at Virginia Hospital Center ... Support patient throughput, utilization management, and quality initiatives by ensuring timely ...

Centerbrite Health

BCBA (Part-time)

Fairfax, VA · On-site +1

$80 - $110/hr

Carry and manage a client caseload , serving as the clinical standard-bearer for the organization ... Own documentation quality , utilization reviews, and oversight of treatment plans * Supervise RBTs ...

Encompass Health

Case Management Director

Aldie, VA · On-site

Affordable medical, dental, and vision plans for both full-time and part-time employees and their ... Three years of hospital-based Case Management experience, including Utilization Review and ...

Encompass Health

Case Management Director

Aldie, VA · On-site

Affordable medical, dental, and vision plans for both full-time and part-time employees and their ... Three years of hospital-based Case Management experience, including Utilization Review and ...

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All JobsUtilization Management JobsPart Time Utilization Management JobsPart Time Utilization Management Jobs in Virginia

Part Time Utilization Management information

What is the difference between Part Time Utilization Management vs Part Time Care Coordinator?

AspectPart Time Utilization ManagementPart Time Care Coordinator
Primary RoleReviewing and approving healthcare services to ensure appropriate utilizationCoordinating patient care plans and services across providers
CertificationsTypically requires healthcare or insurance-related certificationsOften requires healthcare or case management certifications
Work EnvironmentOffice-based, insurance companies, healthcare organizationsHealthcare facilities, clinics, or community health settings
Employer & Industry UsageInsurance companies, managed care organizationsHospitals, clinics, healthcare providers

While both roles involve healthcare coordination, Part Time Utilization Management focuses on reviewing and authorizing services, whereas Part Time Care Coordinators actively manage patient care plans. Understanding these differences helps in choosing the right career path or job search focus.

What are the key skills and qualifications needed to thrive as a part time utilization management professional?

To thrive as a Part Time Utilization Management professional, you need a background in nursing or healthcare, critical thinking skills, and knowledge of medical necessity criteria, often supported by RN or LPN licensure. Familiarity with utilization review software, electronic health records (EHRs), and systems like InterQual or Milliman is typically required. Strong communication, attention to detail, and organizational skills help you effectively coordinate with providers and ensure accurate documentation. These abilities are essential for making informed coverage determinations, optimizing resource use, and maintaining compliance with healthcare regulations.

Is part time utilization management a stressful job?

Part time utilization management can be stressful due to the need to review and approve healthcare services efficiently while meeting deadlines. The role often requires strong organizational skills, attention to detail, and the ability to handle high volumes of cases, which can contribute to work-related stress.

What is a part time utilization management?

A part-time utilization management job involves reviewing and evaluating the medical necessity, appropriateness, and efficiency of healthcare services, procedures, and facilities on a part-time basis. These professionals help ensure that patients receive the right care at the right time while controlling healthcare costs and complying with insurance policies. Part-time roles may be suitable for nurses, social workers, or other healthcare professionals who want flexible hours while contributing to quality patient care and resource management.

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 cities in Virginia are hiring for Part Time Utilization Management jobs?

Cities in Virginia with the most Part Time Utilization Management job openings:

Part Time Utilization Management jobs near you
Infographic showing various Part Time Utilization Management job openings in Virginia as of August 2026, with employment types broken down into 1% As Needed, 84% Full Time, 13% Part Time, and 2% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution.

RN Case Manager - Utilization Management - Part Time

Augusta Medical Center

Fishersville, VA

$35.43 - $54.21/hr

Part-time

Medical, Retirement, PTO

Posted 10 days ago

Job description

The Utilization Review RN Case Manager applies knowledge of medical necessity criteria and regulatory requirements in determining the appropriate patient status for any person destined for a bed on the patient care units. This position works closely with admitting and attending providers as well as the Utilization Management Physician Advisor to ensure patient status is accurate and compliant with regulatory standards. The Utilization Review RN Case Manager is viewed by clinical teams as an expert in the building when it comes to selecting the appropriate level of service for patients. They participate in multidisciplinary discharge rounds on the hospital units to understand clinical course, discharge plans and possible changes in medical necessity, all toward selecting the levels of care that match clinical necessity. This position plays an essential role in securing reimbursement to the hospital for services provided by commercial, Medicaid and Medicare payers through timely communication and submission of relevant clinical information to the payer when required. The effective tending of utilization review lowers the frequency of avoidable denials by payers for services provided. This role ensures adherence to the policies and guidelines of all payer review organizations to secure appropriate reimbursement for patient hospitalizations. During normal business hours this position may screen patients to determine if case management follow-up is required.

Minimum Qualifications

  • Bachelor of Science in Nursing
    OR
  • Associate’s degree in Nursing PLUS three years of experience as an RN
  • Registered nurse license in the Commonwealth of Virginia or from a state that is part of a compact agreement with Virginia
  • Acute care hospital experience or comparable job-related experience in at least 3 of the last 5 years

Preferred Qualifications

  • National certification in case management or utilization management preferred
  • 3 to 5 years of recent experience in utilization review and/or discharge planning in an acute care setting preferred

Skills

  • Comprehensive knowledge of regulatory, legislative, and DNV standards related to utilization review.
  • Proficient in computer skills including navigating EHRs, medical necessity criteria, Microsoft Office products.
  • Effective verbal and written skills with the ability to collaborate with multiple disciplines throughout the organization.
  • Good problem solving and decision-making skills.
  • Excellent organizational skills and the ability to work in a fast-paced environment.

Some benefits of working at Augusta Health include

  • Healthcare Benefits
  • Generous paid time off
  • Retirement savings helping you to plan for your future
  • Free onsite parking
  • 24/7 armed security to ensure your safety
  • Tuition reimbursement
  • Onsite child care
  • Augusta Health Fitness Reimbursement Program
  • Onsite credit union
  • Employee discounts including the cafeteria, gift shop, pharmacy, and movie tickets

Company Information

Augusta Health is a mission-driven, independent, nonprofit, community health system located in Fishersville Virginia in Virginia’s scenic Shenandoah Valley. Augusta Health offers a full continuum of inpatient and outpatient which includes Augusta Medical Center a 255 bed inpatient facility and Augusta Medical Group which is comprised of 40 practice locations and four urgent care locations.

Equal Opportunity

Augusta Health recruits, hires and promotes qualified candidates for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, race, religion, sex (including pregnancy), sexual orientation, veteran or military discharge status, and family medical or genetic information.

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