Utilization Management
Reston, VA · Remote
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 ...
Reston, VA · Remote
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 ...
Reston, VA · Remote
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 ...
May be accountable for the day-to-day management of teams for appropriate implementation and ... remote staff up to 12 direct reports and oversight up to 50) Call Center experience preferred ...
May be accountable for the day-to-day management of teams for appropriate implementation and ... remote staff up to 12 direct reports and oversight up to 50) Call Center experience preferred ...
Ashburn, VA · Remote
$59.50 - $71.50/hr
Remote Prior Authorization Pharmacist - Work From Home in Managed Care A confidential managed care ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Ashburn, VA · Remote
$59.50 - $71.50/hr
Remote Prior Authorization Pharmacist - Work From Home in Managed Care A confidential managed care ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Annandale, VA · Remote
$58 - $69.50/hr
Remote Prior Authorization Pharmacist - Work From Home in Managed Care A confidential managed care ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Annandale, VA · Remote
$58 - $69.50/hr
Remote Prior Authorization Pharmacist - Work From Home in Managed Care A confidential managed care ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Ashburn, VA · On-site +1
$58.50 - $71.25/hr
Prior managed care or utilization management experience preferred - retail and hospital pharmacists ... Many roles offer hybrid or fully remote options. * Rewards: Competitive salary, comprehensive ...
Ashburn, VA · On-site +1
$58.50 - $71.25/hr
Prior managed care or utilization management experience preferred - retail and hospital pharmacists ... Many roles offer hybrid or fully remote options. * Rewards: Competitive salary, comprehensive ...
Annandale, VA · On-site +1
$57 - $69.50/hr
Prior managed care or utilization management experience preferred - retail and hospital pharmacists ... Many roles offer hybrid or fully remote options. * Rewards: Competitive salary, comprehensive ...
Annandale, VA · On-site +1
$57 - $69.50/hr
Prior managed care or utilization management experience preferred - retail and hospital pharmacists ... Many roles offer hybrid or fully remote options. * Rewards: Competitive salary, comprehensive ...
Mclean, VA · On-site +1
Role is remote Preferred * Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Strong desktop skills including Word, Excel, PowerPoint * Work ...
Mclean, VA · On-site +1
Role is remote Preferred * Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Strong desktop skills including Word, Excel, PowerPoint * Work ...
Rosslyn, VA · On-site +1
Role is remote Preferred * Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Strong desktop skills including Word, Excel, PowerPoint * Work ...
Rosslyn, VA · On-site +1
Role is remote Preferred * Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Strong desktop skills including Word, Excel, PowerPoint * Work ...
Richmond, VA · On-site +1
Role is remote Preferred * Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Strong desktop skills including Word, Excel, PowerPoint * Work ...
Richmond, VA · On-site +1
Role is remote Preferred * Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Strong desktop skills including Word, Excel, PowerPoint * Work ...
Rosslyn, VA · On-site +1
Role is remote Preferred * Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Ability to work independently and collaborate as part of a team
Rosslyn, VA · On-site +1
Role is remote Preferred * Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Ability to work independently and collaborate as part of a team
Richmond, VA · On-site +1
Role is remote Preferred * Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Ability to work independently and collaborate as part of a team
Richmond, VA · On-site +1
Role is remote Preferred * Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Ability to work independently and collaborate as part of a team
Mclean, VA · On-site +1
Role is remote Preferred * Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Ability to work independently and collaborate as part of a team
Mclean, VA · On-site +1
Role is remote Preferred * Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Ability to work independently and collaborate as part of a team
Richmond, VA · On-site +1
Role is remote Preferred * Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Analytical/ Decision Making Responsibilities * Analytical ability to ...
Richmond, VA · On-site +1
Role is remote Preferred * Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Analytical/ Decision Making Responsibilities * Analytical ability to ...
Mclean, VA · On-site +1
Role is remote Preferred * Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Analytical/ Decision Making Responsibilities * Analytical ability to ...
Mclean, VA · On-site +1
Role is remote Preferred * Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Analytical/ Decision Making Responsibilities * Analytical ability to ...
Rosslyn, VA · On-site +1
Role is remote Preferred * Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Analytical/ Decision Making Responsibilities * Analytical ability to ...
Rosslyn, VA · On-site +1
Role is remote Preferred * Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Analytical/ Decision Making Responsibilities * Analytical ability to ...
Richmond, VA · Remote
$54K - $155K/yr
Position Summary This is a remote work from home role anywhere in the US with virtual training ... Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization ...
Richmond, VA · Remote
$54K - $155K/yr
Position Summary This is a remote work from home role anywhere in the US with virtual training ... Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization ...
Charlottesville, VA · On-site +1
$76K/yr
... utilization, and address social drivers of health (SDOH). Leads day-to-day operations of care ... management, Interactive Home Monitoring (IHM), Remote Patient Monitoring (RPM), and Remote ...
Charlottesville, VA · On-site +1
$76K/yr
... utilization, and address social drivers of health (SDOH). Leads day-to-day operations of care ... management, Interactive Home Monitoring (IHM), Remote Patient Monitoring (RPM), and Remote ...
Arlington, VA · On-site +1
$28.94 - $51.63/hr
Utilization management, prior authorization, and case management experience * Managed care experience * Ability to create, edit, save and send documents utilizing Microsoft Word. Ability to navigate ...
Arlington, VA · On-site +1
$28.94 - $51.63/hr
Utilization management, prior authorization, and case management experience * Managed care experience * Ability to create, edit, save and send documents utilizing Microsoft Word. Ability to navigate ...
Arlington, VA · Remote
$28.94 - $51.63/hr
Utilization management, prior authorization, and case management experience * Managed care experience * Ability to create, edit, save and send documents utilizing Microsoft Word. Ability to navigate ...
Arlington, VA · Remote
$28.94 - $51.63/hr
Utilization management, prior authorization, and case management experience * Managed care experience * Ability to create, edit, save and send documents utilizing Microsoft Word. Ability to navigate ...
Lead change management efforts to support adoption of new operational processes, technologies, and ... utilization, revenue cycle performance, and cost structures. * Mentor and support operational ...
Lead change management efforts to support adoption of new operational processes, technologies, and ... utilization, revenue cycle performance, and cost structures. * Mentor and support operational ...
$21.21 - $25.50
2% of jobs
$25.50 - $29.79
9% of jobs
$32.73 is the 25th percentile. Wages below this are outliers.
$29.79 - $34.08
21% of jobs
The median wage is $37.55 / hr.
$34.08 - $38.37
23% of jobs
$38.37 - $42.66
13% of jobs
$46 is the 75th percentile. Wages above this are outliers.
$42.66 - $46.95
10% of jobs
$46.95 - $51.24
8% of jobs
$51.24 - $55.53
5% of jobs
$55.53 - $59.82
5% of jobs
$59.82 - $64.11
2% of jobs
$64.11 - $68.40
2% of jobs
$21
$41
$68
| Aspect | Remote Utilization Management | Remote Case Management |
|---|---|---|
| Credentials | RN, LPN, or licensed healthcare professionals | RN, LPN, or social workers |
| Work Environment | Healthcare facilities, insurance companies, telehealth | Healthcare providers, insurance, community agencies |
| Industry Usage | Insurance, healthcare, telehealth | Healthcare, social services, insurance |
| Primary Focus | Reviewing medical necessity, authorizations | Coordinating patient care, support services |
Remote Utilization Management primarily involves reviewing medical necessity and authorizations, while Remote Case Management focuses on coordinating patient care and support services. Both roles require healthcare credentials and are used within healthcare and insurance industries, but they serve different functions in patient care and resource allocation.

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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It services
1,001 - 5,000 Employees
Atlanta, GA, US
1994