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Utilization Care Manager Jobs in Reston, VA (NOW HIRING)

V-Tech Solutions Inc.

RN Care Manager

Washington, DC · Remote

$36.32 - $46/hr

Identify gaps in care and address over- or under-utilization of services * Document care management activities accurately and timely per policy Education & Experience * Associate's Degree in Nursing ...

V-Tech Solutions Inc.

RN Care Manager

Washington, DC · On-site

$36.32 - $46/hr

Identify gaps in care and address over- or under-utilization of services * Document care management activities accurately and timely per policy Education & Experience * Associate's Degree in Nursing ...

Elevance Health

Nurse Case Mgr Sr

Washington, DC · On-site

$83K - $137K/yr

Assists with development of utilization/care management policies and procedures, chairs, and schedules meetings, as well as presents cases for discussion at Grand Rounds/Care Conferences and ...

Elevance Health

Nurse Case Mgr Sr

Ashburn, VA · On-site

$83K - $137K/yr

Assists with development of utilization/care management policies and procedures, chairs, and schedules meetings, as well as presents cases for discussion at Grand Rounds/Care Conferences and ...

Elevance Health

Nurse Case Mgr Sr

Washington, DC

$83K - $137K/yr

Assists with development of utilization/care management policies and procedures, chairs, and schedules meetings, as well as presents cases for discussion at Grand Rounds/Care Conferences and ...

Elevance Health

Nurse Case Mgr Sr

Ashburn, VA · On-site

$83K - $137K/yr

Assists with development of utilization/care management policies and procedures, chairs, and schedules meetings, as well as presents cases for discussion at Grand Rounds/Care Conferences and ...

Elevance Health

Nurse Case Mgr Sr

Washington, DC · On-site

$83K - $137K/yr

Assists with development of utilization/care management policies and procedures, chairs, and schedules meetings, as well as presents cases for discussion at Grand Rounds/Care Conferences and ...

MedStar Health

RN Utilization Management

Washington, DC · On-site

$89K - $162K/yr

About the Job General Summary of Position The RN Utilization Manager will have 1-2 years of ... Responsible for clinical review of acute care services based on Medically Necessity criteria the ...

MedStar Health

RN Utilization Management

Washington, DC · On-site

$89K - $162K/yr

About the Job General Summary of Position The RN Utilization Manager will have 1-2 years of ... Responsible for clinical review of acute care services based on Medically Necessity criteria the ...

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All JobsUtilization Care Manager JobsUtilization Care Manager Jobs in Reston, VA

Utilization Care Manager information

See Reston, VA salary details

$40.6K

$94.7K

$174.3K

How much do utilization care manager jobs pay per year?

As of Jun 29, 2026, the average yearly pay for utilization care manager in Reston, VA is $94,684.00, according to ZipRecruiter salary data. Most workers in this role earn between $61,900.00 and $113,900.00 per year, depending on experience, location, and employer.

How does a Utilization Care Manager typically collaborate with medical and administrative teams to ensure effective patient care?

Utilization Care Managers work closely with physicians, nursing staff, and administrative teams to review patient cases, determine medical necessity, and coordinate appropriate care plans. They frequently participate in interdisciplinary meetings, communicate with insurance providers regarding authorizations, and ensure compliance with regulatory guidelines. This collaborative approach helps to optimize resource utilization, improve patient outcomes, and support smooth transitions of care. Being proactive in communication and documentation is key to success in this role.

What are Utilization Care Managers?

Utilization Care Managers are healthcare professionals responsible for evaluating the necessity, appropriateness, and efficiency of medical services provided to patients. They work to ensure that patients receive the right care at the right time, while also helping healthcare organizations manage costs and comply with regulations. Utilization Care Managers often review patient cases, coordinate with medical staff, and interact with insurance companies to authorize or deny services. Their goal is to optimize healthcare delivery, reduce unnecessary procedures, and improve patient outcomes.

What jobs pay 2000 a day?

Jobs that can pay $2,000 a day typically include specialized roles such as senior management, high-level consultants, certain medical professionals like surgeons, and experienced freelance contractors in fields like software development or engineering. These positions often require advanced skills, extensive experience, or professional certifications, and may involve project-based or contract work with high hourly or daily rates.

What does a utilization manager do in healthcare?

A utilization care manager in healthcare evaluates the necessity, appropriateness, and efficiency of medical services provided to patients. They review patient cases, coordinate with healthcare providers, and ensure that care plans align with insurance policies and clinical guidelines to optimize resource use and control costs.

What are the key skills and qualifications needed to thrive as a Utilization Care Manager, and why are they important?

To thrive as a Utilization Care Manager, you need a background in healthcare, typically as a registered nurse or social worker, with expertise in care coordination and utilization review. Familiarity with utilization management software, medical necessity guidelines (such as Milliman or InterQual), and knowledge of insurance regulations are important. Strong analytical thinking, attention to detail, and effective communication skills help you advocate for patients while working with healthcare teams and payers. These skills ensure appropriate resource use, quality patient outcomes, and compliance with regulatory standards.

What is the highest paying job with a BSW?

The highest paying jobs with a Bachelor of Social Work (BSW) degree typically include roles such as clinical social worker, healthcare administrator, or mental health director, with salaries often exceeding $70,000 annually. Advancement to supervisory or administrative positions, along with additional certifications or experience, can lead to higher compensation in social services and healthcare settings.

What job makes $10,000 a month without a degree?

A Utilization Care Manager typically does not earn $10,000 a month without a degree, as this role usually requires healthcare or administrative certifications and experience. High-paying jobs that can reach this level without a degree often include specialized sales, real estate brokers, or skilled trades like certain construction or technical roles, but these usually require relevant skills, licenses, or extensive experience.

What is the difference between Utilization Care Manager vs Utilization Review Nurse?

AspectUtilization Care ManagerUtilization Review Nurse
CredentialsRN, case management certificationRN, certification in utilization review
Work EnvironmentHealthcare facilities, insurance companiesHospitals, insurance companies, outpatient clinics
Primary FocusCoordinating patient care, managing resourcesReviewing medical necessity, approving treatments

Utilization Care Managers focus on coordinating patient care and managing resources, while Utilization Review Nurses primarily evaluate medical necessity for treatments. Both roles require nursing credentials and work within healthcare or insurance settings, but their core responsibilities differ in scope and focus.

What are popular job titles related to Utilization Care Manager jobs in Reston, VA? For Utilization Care Manager jobs in Reston, VA, the most frequently searched job titles are:
What job categories do people searching Utilization Care Manager jobs in Reston, VA look for? The top searched job categories for Utilization Care Manager jobs in Reston, VA are:
What cities near Reston, VA are hiring for Utilization Care Manager jobs? Cities near Reston, VA with the most Utilization Care Manager job openings:
Utilization Care Manager jobs near you
RN Care Manager

RN Care Manager

V-Tech Solutions Inc.

Washington, DC • Remote

$36.32 - $46/hr

Contractor

Posted 4 days ago

Job description

Position Summary

V- Tech Solutions is seeking a Registered Nurse (RN) Care Manager to provide comprehensive care coordination services for children and young adults with special healthcare needs. The RN Care Manager assesses member needs, develops and monitors individualized care plans, coordinates services, and collaborates with families, providers, and community partners to improve health outcomes and quality of life.

Key Responsibilities:
  • Manage a caseload of members with high-complexity medical and behavioral health needs
  • Conduct health assessments, outreach, and community or home visits
  • Develop, implement, and monitor individualized care plans based on acuity
  • Coordinate care with physicians, specialists, caregivers, and multidisciplinary teams
  • Support hospital discharge planning and transitions of care
  • Educate members and caregivers on conditions, medications, and self-management. Identify gaps in care and address over- or under-utilization of services
  • Document care management activities accurately and timely per policy
Education & Experience
  • Associate's Degree in Nursing required (Bachelor's Degree preferred)
  • Minimum 2 years of experience in care management, discharge planning, home health, or managed care
  • At least 1 year of experience in a public or community health setting
Licensure & Certification:
  • Active Registered Nurse (RN) license in Washington, DC (required upon hire)
  • Certified Case Manager (CCM) preferred
Key Skills:
  • Care coordination and case management
  • Clinical assessment and care planning
  • Discharge planning and care transitions
  • Knowledge of disease processes and standards of care
  • Community resource navigation
  • Electronic health record documentation
  • Strong written, verbal, and interpersonal communication
  • Time management and organizational skills
  • Cultural competence and family-centered care
Work Environment

Hybrid position with office-based and community-based work.