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Utilization Management Clinical Analyst Jobs in Virginia

Resource Point LLC

Epic Clinical Analyst

Arlington, VA · On-site

Epic Clinical Analyst Job Type: Permanent Location: Arlington, VA Our client is seeking an Epic ... Provides 24/7 problem management support and resolution for clinical systems * Key attention to the ...

UHS

Director of Utilization Management

Danville, VA · On-site

$79K - $95K/yr

This position interacts and communicates with clinical staff, the Business Office, Admissions ... Three to five years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, ...

VHC Health

Epic Clinical Analyst III

Alexandria, VA · On-site

Position Title Epic Clinical Analyst III Purpose & Scope: This position is responsible for the ... Must possess strong communication and organization skills. • Proven project management experience ...

VHC Health

Epic Clinical Analyst I

Alexandria, VA · On-site

The analyst typically fulfills multiple roles throughout the development, implementation, management, and on-going support of comprehensive clinical information systems. Gains knowledge of the Epic ...

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Utilization Management Clinical Analyst information

How does a utilization management clinical analyst typically collaborate with clinical and administrative teams to ensure optimal patient care?

A Utilization Management Clinical Analyst works closely with both clinical staff, such as nurses and physicians, and administrative teams to review patient cases and ensure that treatments and services are medically necessary and align with payer guidelines. This role often involves participating in interdisciplinary meetings, communicating findings and recommendations, and helping to develop or refine care protocols. Effective collaboration is essential to balance quality patient care with cost efficiency, and analysts regularly provide feedback and support to improve clinical workflows and documentation.

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

To thrive as a Utilization Management Clinical Analyst, you need a solid background in healthcare, strong analytical abilities, and credentials such as RN or LPN licensure or relevant clinical certifications. Familiarity with utilization management software, electronic health records (EHRs), and claims processing systems is typically required. Excellent communication, critical thinking, and attention to detail are soft skills that help you collaborate effectively and make sound clinical determinations. These competencies are crucial for ensuring the appropriate use of medical resources, maximizing patient outcomes, and maintaining regulatory compliance.

What does a utilization management clinical analyst do?

A Utilization Management Clinical Analyst reviews and analyzes medical records, claims, and treatment plans to ensure that healthcare services provided to patients are medically necessary and cost-effective. They work with healthcare providers, insurance companies, and patients to evaluate the appropriateness of medical care based on established guidelines and policies. Their goal is to optimize patient outcomes while controlling healthcare costs and ensuring compliance with regulatory standards.

What is the difference between Utilization Management Clinical Analyst vs Utilization Review Nurse?

AspectUtilization Management Clinical AnalystUtilization Review Nurse
CredentialsHealthcare degree, certifications like CCM or CUCRegistered Nurse (RN), state licensure, certifications like CCM
Work EnvironmentInsurance companies, healthcare organizations, utilization review departmentsHospitals, insurance companies, outpatient facilities
Employer & IndustryHealth insurance providers, managed care organizationsHospitals, insurance companies, healthcare facilities
Common Search & ComparisonUtilization Management Clinical Analyst vs Utilization Review Nurse

The main difference between a Utilization Management Clinical Analyst and a Utilization Review Nurse lies in their focus and credentials. Clinical Analysts often have healthcare degrees and certifications like CCM, working primarily in insurance or managed care settings. Utilization Review Nurses are registered nurses with licensure, working in hospitals or outpatient facilities. Both roles involve reviewing medical necessity, but their work environments and professional backgrounds differ.

What are popular job titles related to Utilization Management Clinical Analyst jobs in Virginia?

For Utilization Management Clinical Analyst jobs in Virginia, the most frequently searched job titles are:

What job categories do people searching Utilization Management Clinical Analyst jobs in Virginia look for?

The top searched job categories for Utilization Management Clinical Analyst jobs in Virginia are:

What cities in Virginia are hiring for Utilization Management Clinical Analyst jobs?

Cities in Virginia with the most Utilization Management Clinical Analyst job openings:

Utilization Management Clinical Analyst jobs near you
Infographic showing various Utilization Management Clinical Analyst job openings in Virginia as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution.

Epic Clinical Analyst

Resource Point LLC

Arlington, VA • On-site

Full-time

Re-posted 27 days ago

Job description

Job Title: Epic Clinical Analyst

Job Type: Permanent

Location: Arlington, VA

Job Description

Our client is seeking an Epic Clinical Analyst responsible for establishing credibility at all levels including clinical providers and builds problem-solving partnerships with customers and colleagues.

The Epic Clinical Analyst works independently in completing project tasks and executing the following tasks as part of a clinical systems implementation.

Responsibilities:

  • Building system components; testing, documentation of workflows and other project information
  • Implementation support and maintenance of Epic clinical system software
  • Builds data sets, master files and reports
  • Performs quality assurance and integrated testing and releases new functionality to end-users
  • Reviews vendor software releases and updates
  • Provides 24/7 problem management support and resolution for clinical systems
  • Key attention to the build and workflow requirements needed to achieve and maintain federal incentive programs, for example, Meaningful Use
  • Dedicated attention and resources to make rapid adjustments to improve compliance to federal initiative, reporting of outcomes related to patient safety and quality

Requirements:

  • Bachelor's degree is required (or four years equivalent experience); Preferred degree in: Health Care Administration, Clinical Information Systems, Informatics, Information Technology, or Sciences; RN, RRT, RPH, ARNP, PA degrees may also be acceptable
  • 1+ years of healthcare industry experience preferably in a hospital or major medical center clinical setting
  • 1+ years of EHR experience, either as an analyst or end-user
  • Ability to interact with clients and demonstrate critical thinking and follow through when developing solutions to identified issues
  • Knowledge of operational healthcare hospital workflows
  • Hands-on clinical systems experience (Epic preferred)
  • Demonstrated ability to work with and facilitate multidisciplinary clinician groups as part of a clinical information system support, preferred
  • Experience educating staff on the use of systems, preferably in a healthcare environment, is highly desired
  • Experience in project planning and procedural analysis preferred
  • Basic knowledge of and ability to work with SDLC concepts
  • Excellent written and oral communications skills, especially active listening and writing