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Remote Supervisor Utilization Management Jobs in Virginia

... utilization review, or managed care experience; or any combination of education and experience ... No weekends, holidays or overtime * 100% Remote (50 miles or 1 hour commute from a Pulse Point ...

... utilization review, or managed care experience; or any combination of education and experience ... No weekends, holidays or overtime * 100% Remote (50 miles or 1 hour commute from a Pulse Point ...

This is a remote position. **Please note that this position is contingent upon bid award ... management meetings and conduct shift/team meetings with Supervisors. Minimum Requirements ...

Fully remote will be considered for the right candidate. Standard work hours: Due to the varied ... The Procurement Manager supervises assigned buyers, directs and prioritizes the team's daily ...

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Remote Supervisor Utilization Management information

What is the highest paying job in healthcare management?

In healthcare management, executive roles such as Chief Executive Officer (CEO), Chief Operating Officer (COO), and Chief Medical Officer (CMO) tend to be the highest paying positions, often earning six-figure salaries. These roles require extensive experience, leadership skills, and often advanced degrees or certifications, and they oversee large healthcare organizations or systems.

How to make 2000 a week working from home?

A Remote Supervisor Utilization Management can earn $2,000 or more weekly by working full-time, managing multiple cases efficiently, and possessing relevant certifications such as CCM or ANCC. Increasing experience, demonstrating strong organizational skills, and working for organizations with higher pay scales can also help achieve this income level.

Is a utilization manager the same as a risk manager?

A utilization management supervisor focuses on evaluating healthcare services to ensure appropriate and efficient use of resources, often within insurance or healthcare organizations. A risk manager, on the other hand, identifies and mitigates potential risks to an organization, which can include financial, legal, or safety concerns. While both roles involve assessment and decision-making, they serve different functions and require distinct skill sets.

How to make $1000 a week remotely?

A Remote Supervisor Utilization Management role can pay around $1,000 or more per week depending on experience, certifications, and workload. Earning this amount typically involves managing a high volume of cases, utilizing strong organizational skills, and working full-time hours, often with overtime or bonuses for productivity. Building expertise in utilization review and maintaining relevant credentials can help increase earning potential in remote management positions.

What is the difference between Remote Supervisor Utilization Management vs Remote Utilization Review Nurse?

AspectRemote Supervisor Utilization ManagementRemote Utilization Review Nurse
CredentialsRN, often with management or supervisor certificationsRN, with clinical review certifications
Work EnvironmentSupervises teams, manages utilization processes remotelyPerforms clinical reviews, assesses patient necessity remotely
Employer & Industry UsageHealth insurance companies, managed care organizationsInsurance companies, third-party administrators
Primary FocusOverseeing utilization management operationsConducting clinical utilization reviews

Remote Supervisor Utilization Management roles focus on overseeing utilization management teams and processes, ensuring compliance and efficiency. In contrast, Remote Utilization Review Nurses primarily perform clinical assessments to determine the necessity of services. Both roles require RN credentials but differ in responsibilities and scope within the utilization management field.

What cities in Virginia are hiring for Remote Supervisor Utilization Management jobs? Cities in Virginia with the most Remote Supervisor Utilization Management job openings:
Infographic showing various Remote Supervisor Utilization Management job openings in Virginia as of July 2026, with employment types broken down into 1% As Needed, 82% Full Time, 14% Part Time, 1% Temporary, and 2% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution.
Manager of Utilization Management/Concurrent Review MCO

Manager of Utilization Management/Concurrent Review MCO

Aetna

Richmond, VA • Remote

Full-time

Medical, Retirement

Re-posted 22 days ago


Job description

Company Description

Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come. Excellent benefits package, including 401k, tuition, licensure and certification reimbursement. We promote healthy & wellness lifestyles and offer specialty programs here at Aetna.
We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.
Together we will empower people to live healthier lives.
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.
We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.

Job Description

POSITION SUMMARY
The dedication of talented and caring health care professionals drives the delivery of high quality, cost effective products and services. They make it possible for members to get the right health care treatment for their needs and for Aetna to keep its competitive edge.

Standard business hours and no holidays nor nights.
Fundamental Components but not limited to the following:
Reinforces clinical philosophy, programs, policies and procedures. Communicates strategic plan and specific tactics to meet plan. Ensures implementation of tactics to meet strategic direction for cost and quality outcomes. Creates direction and communicates a business case for change by focusing on and addressing key priorities to achieve business results. Identifies opportunities to implement best practice approaches and introduce innovations to better improve outcomes. Accountable for meeting the financial, operational and quality objectives of the unit. May be accountable for the day-to-day management of teams for appropriate implementation and adherence with established practices, policies and procedures if there is not supervisor position Works closely with functional area managers to ensure consistency in clinical interventions supporting our plan sponsors. Develop, initiate, monitor and communicate performance expectations. May act as a single point of contact for the customer and the Account Team which includes participation in customer meetings, implementation and oversight of customer cultural requirements, and support implementation of new customers. Participate in the recruitment and hiring process for staff using clearly defined requirements in terms of education, experience, technical and performance skills. Assesses developmental needs and collaborates with others to identify and implement action plans that support the development of high performing teams. Consistently demonstrates the ability to serve as a model change agent and lead change efforts. Accountable for maintaining compliance with policies and procedures and implements them at the employee level. Ability to evaluate and interpret data, identify areas of improvement, and focuses on interventions to improve outcomes.

Qualifications

BACKGROUND/EXPERIENCE:
5 years in clinical area of expertise

1+ year previous leadership experience (management of onsite and remote staff up to 12 direct reports and oversight up to 50)
Call Center experience preferred
Utilization Manager experience preferred 
Previous Managed Care experience preferred 
EDUCATION
The minimum level of education for candidates in this position is a Bachelor's degree or equivalent experience.
LICENSES AND CERTIFICATIONS
Nursing/Registered Nurse (RN) is required, active and unrestricted for the state of Virginia or compact including state of VA.
FUNCTIONAL EXPERIENCES
Functional - Medical Management/Medical Management - Hospital/3 Years
Functional - Management/Management - Health Care Delivery/3 Years
Functional - Clinical / Medical/Precertification/3 Years
Telework Specifications:
Telework would be an option once a week once fully trained and competent in the role
ADDITIONAL JOB INFORMATION
Become apart of a Fortune 500 company with the ability for professional growth 

Additional Information

All your information will be kept confidential according to EEO guidelines.


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About aetna

Sourced by ZipRecruiter

Industry

Insurance services, fitness and sports centers and clean energy semiconductors manufacturing

Company size

10,000+ Employees

Headquarters location

Hartford, CT, US

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