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Utilization Management Case Manager Rn Jobs in Virginia

The RN Case Manager 1 provides discharge planning and continuity of care for assigned patients in ... Uses utilization management techniques to determine the medical necessity, appropriateness and ...

Uses utilization management techniques to determine the medical necessity, appropriateness and ... Registered Nurse (RN) Case Manager 1 Job Responsibilities: * Collects delay and other data for ...

Uses utilization management techniques to determine the medical necessity, appropriateness and ... Registered Nurse (RN) Case Manager 1 Job Responsibilities: * Collects delay and other data for ...

Showing results 41-60

Utilization Management Case Manager Rn information

What is the difference between Utilization Management Case Manager Rn vs Utilization Review Nurse?

AspectUtilization Management Case Manager RnUtilization Review Nurse
CredentialsRN license, certification in case management (e.g., CCM)RN license, often with certification in utilization review
Work EnvironmentInsurance companies, healthcare facilities, case management teamsHospitals, insurance companies, outpatient clinics
Primary FocusCoordinating patient care, managing cases, ensuring appropriate utilizationReviewing medical necessity, approving or denying services
Common TasksAssessing patient needs, developing care plans, liaising with providersEvaluating medical records, making utilization decisions, ensuring compliance

The main difference is that the Utilization Management Case Manager Rn focuses on coordinating patient care and managing cases, while the Utilization Review Nurse primarily reviews medical records to approve or deny services. Both roles require RN licensure and related certifications, but their daily responsibilities and work environments differ slightly.

Are utilization management case managers in demand?

Utilization management case managers are in demand due to the growing need for healthcare cost control and efficient patient care coordination. Employers in healthcare organizations, insurance companies, and managed care plans seek professionals with strong clinical knowledge, certification, and experience in utilization review processes. The role offers stable employment opportunities as healthcare systems focus on cost-effective treatment management.

What cities in Virginia are hiring for Utilization Management Case Manager Rn jobs?

Cities in Virginia with the most Utilization Management Case Manager Rn job openings:

Infographic showing various Utilization Management Case Manager Rn job openings in Virginia as of June 2026, with employment types broken down into 79% Full Time, 16% Part Time, and 5% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution.

Case Manager Registered Nurse RN PRN

Richmond, VA โ€ข On-site

$32.95 - $49.42/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 23 days ago


Job description

Case Manager Registered Nurse RN PRN

Hourly Wage Estimate: $32.95 - $49.42 / hour Learn more about the benefits offered for this job.

The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range.

Ready for a role that supports your unique calling in patient care and fits your life? At Henrico Doctors' Hospital, you'll find clear pathways to advance backed by our unmatched nationwide transfer policy that lets you grow your career when the time is right for you. With mentorship opportunities, clinical education courses, professional certification support, and educational assistance, you will have all the resources you need to build the career of a lifetime.

Job Summary and Qualifications

As a Case Manager, your role will be to support patients and families through every step of their care journey. You will coordinate services, connect resources, and develop care plans that reflect each patient's unique needs. By partnering with physicians, nurses, and department leaders, you will help ensure safe transitions, clear communication, and consistent quality across the continuum of care.

Your responsibilities will include:

  • Guiding patients and families through program orientation, explaining the rehabilitation philosophy, Medicare and insurance benefits, discharge criteria, and patient rights
  • Coordinating education for patients, families, and caregivers to encourage participation in treatment planning, goal discussions, and family conferences
  • Developing and implementing individualized treatment plans that reflect the patient's strengths, needs, and personal recovery goals
  • Completing psychosocial assessments and discharge planning evaluations, clearly documenting findings and communicating needs across the care team
  • Collaborating closely with the Rehab Program Director, Facility Case Management Director, and interdisciplinary team to ensure seamless, patient-centered care
  • Promoting HCA Healthcare's values of compassion, respect, and excellence through every patient and family interaction
What qualifications you will need:
  • Required minimum of five years of recent clinical experience as a RN
  • Commercial Utilization Management and/or Case Management experience; Quality Management Experience preferred
  • Graduate of an accredited school of nursing
  • Bachelor's Degree preferred
  • Licensed a Registered Nurse in the Commonwealth of Virginia or has a Compact license
  • Basic Life Support (BLS) certification

Henrico Doctors' Hospital, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

  • Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
  • Wellbeing support, including free counseling and referral services
  • Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
  • Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
  • Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
  • Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

Established in 1974, Henrico Doctors' Hospital is a 340-bed community hospital offering cardiology, gastroenterology, neurology, oncology, physical therapy, women's services and a 24/7 emergency department. Operated by HCA Healthcare, Henrico Doctors' Hospitals consists of three community campuses - Henrico, Parham, and Retreat Doctors' Hospitals along with a free-standing emergency center, Hanover Emergency Center. Envisioned, founded and supported by a group of independent physicians looking to provide high-quality care in an accessible community setting, Henrico Doctors' proudly remains committed to providing patients with the best care possible.

"Nurses are essential to the delivery of healthcare and serve as its foundation. At HCA Healthcare, we are committed to equipping nurses with the tools and resources they need to deliver exceptional patient care, championing the profession, and supporting the advancement of nursing's future."

Erica Rossitto, MBA/HCM, BSN, RN, NEA-BC

Senior Vice President and Chief Nurse Executive

HCA Healthcaret

Join a family that cares about every stage in your career! We are interviewing candidates for our Case Manager Registered Nurse RN PRN opening. Apply today and a member of our Talent Acquisition team will reach out.

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.