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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 · 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 ...

Volunteers of America

Clinical Care Manager

Lanham, MD · On-site

$101K - $134K/yr

Is accountable for meeting organizational and participant outcomes and utilization goals. Required ... care settings. * Provides oversight, management, and direction of the overall operational ...

Luminis Health

Utilization Management Nurse

Lanham, MD

$34 - $55/hr

Monitors and identifies patterns or trends in utilization management; monitors potential and actual ... Collaborates with the Care Coordinator to achieve optimal and efficient patient outcomes while ...

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All JobsUtilization Care 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 Aug 3, 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.

What does a utilization manager do?

A utilization care manager evaluates healthcare services to ensure they are necessary, appropriate, and cost-effective. They review patient cases, coordinate with healthcare providers, and use medical records and guidelines to optimize resource use and improve patient outcomes.

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.

Is being a MOA a good entry level job?

A Medical Office Assistant (MOA) role is often considered an entry-level position in healthcare, requiring basic administrative and clinical skills. It provides experience in patient communication, medical records, and office procedures, which can serve as a foundation for advanced healthcare roles. However, career growth may require additional certifications or training.

What jobs pay 4000 a week without a degree?

Utilization Care Managers typically do not earn $4,000 weekly without specialized experience or certifications. High-paying roles that can reach this level without a degree often include skilled trades such as commercial pilots, real estate brokers, or sales managers, which may require licensing or extensive experience. Most jobs paying this amount without a degree involve specialized skills, certifications, or significant experience in the field.

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 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 is the highest paying healthcare administration job?

In healthcare administration, executive roles such as Chief Executive Officer (CEO), Chief Operating Officer (COO), and Chief Financial Officer (CFO) tend to have the highest salaries, often exceeding six figures annually. These positions require extensive experience, leadership skills, and often advanced degrees like an MBA or healthcare administration certification.
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

Clinical Care Manager

VOANS Senior Community Care of Maryland

Lanham, MD

$101K - $134K/yr

Full-time

Re-posted 2 days ago

Job description

Come join our awesome team as a Clinic Manager at the Senior Community Care of Maryland PACE clinic. With awesome benefits and great work environments you will love it here!

Senior Community Care of Maryland PACE is part of Volunteers of America National Services which serves as the Housing and Healthcare affiliate of the Volunteers of America parent organization.

Job Highlights:

  • 403(b) Retirement Plan;
  • Career scholarships;
  • Quality training, continuing career education and leadership programs;
  • Medical, Dental and Vision Insurance
  • Paid Time Off (Vacation, Holiday & Sick Days

Benefits with minimal to no cost to employees: \

  • Employee Assistance Program (EAP)
  • Wellness program
  • Life insurance (with an option to purchase additional)
  • Short term disability
  • Loan program
  • NEW! NetSpend – Get paid early: Tap into 50% of your earnings after payday.
  • Ministry Program

About the job:

Pay: $101,000-$134,000 annually

Schedule: Monday-Friday 8:00 AM-5:30 PM plus on call-rotations

The Clinic Manager under the supervision of the Director of Clinical Services, oversees and manages the overall clinical effectiveness of Senior Community Care (SCC) clinical services to ensure the efficiency, consistency, continuity, and quality of care provided to program participants. Is accountable for meeting organizational and participant outcomes and utilization goals.

Required Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Required Qualifications:

  • Associate Degree in Nursing (RN),
  • Unencumbered license as a Registered Nurse (RN) in the State employed required.
  • Proven experience leading a team of professionals
  • A minimum of one year’s experience in working with the frail or elderly population.
  • Must have a valid driver’s license, proof of insurance and have means of transportation
  • Must have medical clearance for communicable diseases and up-to-date immunizations after having direct participant contact.

Preferred Qualifications:

  • Bachelor’s Degree from an accredited school in nursing preferred.

Essentials:

  • Provides oversight of the overall effectiveness of clinical care provided to SCC participants across all care settings and is responsible for meeting defined organizational participant outcome, utilization, and quality goals.
  • Provides oversight, management, and coordination of the consistency and quality of the twenty- four (24) hour care provided to program participants across all care settings.
  • Provides oversight, management, and direction of the overall operational effectiveness of PACE clinics and is responsible for effectuating and maintaining effective and efficient operational systems, processes, and workflows in compliance with applicable regulations and organizational policies to meet participant care needs and organizational objectives. This includes, but is not limited to, staffing schedules, inventory management and procurement, policies and procedures, clinical workflows, etc.
  • Provides direct supervision and support of the Nursing Staff, Triage Nurse, Clinic Support Staff, and Medication Department Staff.
  • Develop and manage the overall clinic schedule for nurses and clinic support staff, including the on-call schedule.

Participates in the nursing on-call schedule.

  • Manage inventory of clinic supplies, coordinating with the clinic secretary for supply procurement.

Senior Community Care of Maryland - PACE:

Senior Community Care of Maryland - PACE is part of Volunteers of America National Services which serves as the Housing and Healthcare affiliate of the Volunteers of America parent organization.

PACE is a Program of All-Inclusive Care for the Elderly. Our team members include clinical professionals, personal care providers, van drivers, activity assistants and culinary employees among others. Unlike some clinical environments, PACE centers offer employees flexible work schedules, with most positions only requiring occasional weekends. Team members have an opportunity to get to know their patients and build meaningful relationships. SCCMD helps foster a work-life balance by offering employees paid-time off benefits as part of our comprehensive benefits package.

With the internal slogan "The care you need to remain in the home you LOVE", this "one stop shop" prides itself in building relationships with the participants as well as their families, and creating personalized care plans that work for everyone. This vibrant, young, and diverse team lives in close proximity to the beach and the mountains, as well as surrounded by highly regarded colleges and universities and access to premier healthcare. Join us at Senior Community Care of North Carolina and become a part of a healthcare team that is dedicated to creating thoughtful, caring and flexible work environments for our team members.

In our 2022 Great Place to Work survey, employees said their work has a special meaning: this is not “just a job”.

Create happiness for those who need it. Join us today!

At VOANS, we celebrate sharing, encouraging and embracing diversity. Equal employment opportunities are available to all without regard to race, color, religion, sex, pregnancy, national origin, age, physical and mental disability, marital status, parental status, sexual orientation, gender identity, gender expression, genetic information, military and veteran status, and any other characteristic protected by applicable law. We believe that blending individual strengths and unique personal differences nurtures and supports our organizations’ shared commitment to our mission and creates an inclusive and diverse environment where everyone feels valued and has the opportunity to do their personal best.