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Utilization Management Assistant Jobs in Virginia

Evolent

Radiology Physician

Arlington, VA · On-site

$368K - $460K/yr

May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. * Participates in on-going ...

UHS

UTILIZATION REVIEW COORDINATOR

Danville, VA

Our team also works diligently to address or manage medical conditions and challenging behaviors ... · Assist in preparing Utilization Review Reports as necessary. · Coordinates and makes ...

UHS

UTILIZATION REVIEW COORDINATOR

Danville, VA · On-site

Our team also works diligently to address or manage medical conditions and challenging behaviors ... · Assist in preparing Utilization Review Reports as necessary. · Coordinates and makes ...

UHS

UTILIZATION REVIEW COORDINATOR

Danville, VA

Our team also works diligently to address or manage medical conditions and challenging behaviors ... · Assist in preparing Utilization Review Reports as necessary. · Coordinates and makes ...

UHS

UTILIZATION REVIEW COORDINATOR

Danville, VA · On-site

$26 - $35/hr

Our team also works diligently to address or manage medical conditions and challenging behaviors ... Assist in preparing Utilization Review Reports as necessary. • Coordinates and makes ...

UHS

UTILIZATION REVIEW COORDINATOR

Danville, VA

Our team also works diligently to address or manage medical conditions and challenging behaviors ... · Assist in preparing Utilization Review Reports as necessary. · Coordinates and makes ...

Evolent

Oncology - Radiation Physician

Arlington, VA · On-site

May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. * Participates in on-going ...

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All JobsUtilization Management JobsUtilization Management Assistant JobsUtilization Management Assistant Jobs in Virginia

Utilization Management Assistant information

See Virginia salary details

$28.8K

$48K

$68.9K

How much do utilization management assistant jobs pay per year?

As of Sep 5, 2026, the average yearly pay for utilization management assistant in Virginia is $47,981.00, according to ZipRecruiter salary data. Most workers in this role earn between $41,600.00 and $48,100.00 per year, depending on experience, location, and employer.

What is a utilization management assistant?

A Utilization Management Assistant is a healthcare administrative professional who supports the utilization management team by handling clerical tasks, coordinating communications, and organizing patient documentation. They often help ensure that medical services are used efficiently and that insurance requirements are met by gathering information, processing authorizations, and maintaining records. This role is essential in facilitating collaboration between healthcare providers, insurance companies, and patients, ultimately helping to optimize the quality and cost-effectiveness of patient care.

What are the key skills and qualifications needed to thrive as a utilization management assistant?

To thrive as a Utilization Management Assistant, you need a solid understanding of healthcare processes, medical terminology, and administrative procedures, often supported by a high school diploma or associate's degree. Familiarity with electronic health records (EHR) systems, insurance verification tools, and Microsoft Office Suite is typically required. Strong organizational skills, attention to detail, and effective communication are crucial soft skills for managing documentation and collaborating with clinical teams. These skills ensure accurate data handling, efficient workflow, and compliance with healthcare regulations, all of which are vital for successful utilization management operations.

What are some common challenges utilization management assistants face when working with insurance pre-authorizations?

Utilization Management Assistants often encounter challenges such as navigating complex insurance requirements, meeting tight deadlines for pre-authorization requests, and communicating effectively with both healthcare providers and insurance representatives. Staying organized and detail-oriented is essential to ensure all documentation is accurate and submitted promptly. Additionally, adapting to frequent changes in insurance policies and maintaining strong problem-solving skills are key to overcoming these obstacles.

Is utilization management assistant a good job?

Utilization Management Assistants support healthcare organizations by reviewing medical records and authorizations to ensure appropriate care and cost management. The role typically requires attention to detail, knowledge of healthcare policies, and proficiency with electronic health records systems. It can offer stable employment with opportunities for advancement in healthcare administration.

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 Utilization Management Assistant jobs?

Cities in Virginia with the most Utilization Management Assistant job openings:

Utilization Management Assistant jobs near you
Infographic showing various Utilization Management Assistant job openings in Virginia as of August 2026, with employment types broken down into 100% Full Time. Highlights an 91% In-person, and 9% Hybrid job distribution, with an average salary of $47,981 per year, or $23.1 per hour.

REMOTE Physician Clinical Reviewer-Internal Medicine

Evolent

Arlington, VA • On-site

Other

Re-posted 4 days ago

Evolent rating

8.4

Company rating: 8.4 out of 10

Based on 18 frontline employees who took The Breakroom Quiz

73rd of 500 rated business services

Job description

Job Description

As a FMD, Radiology, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients lives, in a non-clinical environment. You can enjoy better work- life balance on a team that values collaboration and continuous learning while providing better health outcomes.



Collaboration Opportunities:  


  • Routinely interacts with leadership and management staff, other Physicians, and staff whenever a physician`s input is needed or required.



What You Will Be Doing:


  • Serve as the Physician match reviewer in Imaging cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter expert.

  • Discusses determinations (peer to peer phone calls) with requesting physicians or ordering providers, when available, within the regulatory timeframe of the request and provides clinical rationale for standard and expedited appeals.

  • Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines.

  • Aids and acts as a resource to Initial Clinical Reviewers.

  • Ensures documentation of all communications with medical office staff and/or MD provider is recorded in a timely and accurate manner.

  • May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support.

  • Participates in on-going training per inter-rater reliability process.



Qualifications:


  • MD/DO/MBBS

  • Minimum of five (5) years’ experience in the practice of Medicine, post residency and Active Clinical practice within the last 2 years is preferred

  • Current, unrestricted clinical home state license in medicine or required specialty-

  • Obtaining and maintaining medical licenses in the state you reside, as well as, any license required per business needs

  • Active Board Certification by an accredited organization

  • Strong clinical, management, communication, and organizational skills

  • Energetic and curious with a passion for quality and value in health care

  • Computer Proficiency

  • Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as an “excluded person” by the Office of Inspector General of the Department of Health and Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by Medicare.

  • No history of a major disciplinary or legal action by a state medical board

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