ZipRecruiter

Log In

1

Utilization Management Coordinator Jobs in Virginia

Summit BHC

Utilization Specialist

Williamsburg, VA · On-site

Coordinates, performs, and monitors all utilization review/management activities of the hospital to continuously improve the collection, reimbursement, coordination, and presentation of utilization ...

Summit BHC

Utilization Specialist - Acute

Williamsburg, VA · On-site

$24 - $28/hr

Coordinates, performs, and monitors all utilization review/management activities of the hospital to continuously improve the collection, reimbursement, coordination, and presentation of utilization ...

UHS

UTILIZATION COORDINATOR

Danville, VA · On-site

... and payor and managing timely transitions through the phases of residential care. Key ... · Assist in preparing Utilization Review Reports as necessary. · Coordinates and makes ...

Elevance Health

Managed Care Coordinator

Norfolk, VA · On-site

Coordinates those members' cases with the clinical healthcare management and interdisciplinary team ... utilization of services. * Establishes short- and long-term goals in collaboration with the member ...

Elevance Health

Managed Care Coordinator

Richmond, VA · On-site

$25 - $31.25/hr

Coordinates those members' cases with the clinical healthcare management and interdisciplinary team ... utilization of services. * Establishes short- and long-term goals in collaboration with the member ...

next page

Showing results 1-20

All JobsUtilization Management JobsUtilization Management Coordinator JobsUtilization Management Coordinator Jobs in Virginia

Utilization Management Coordinator information

See Virginia salary details

$15

$29

$46

How much do utilization management coordinator jobs pay per hour?

As of Aug 15, 2026, the average hourly pay for utilization management coordinator in Virginia is $29.35, according to ZipRecruiter salary data. Most workers in this role earn between $21.20 and $34.33 per hour, depending on experience, location, and employer.

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

To thrive as a Utilization Management Coordinator, you need a background in healthcare or nursing, knowledge of medical terminology, and experience in case management or utilization review, often supported by a relevant degree or certification (such as RN or LPN). Familiarity with utilization management software, electronic health records (EHRs), and insurance authorization platforms is typically required. Strong organizational skills, attention to detail, and effective communication are essential soft skills for this role. These capabilities ensure accurate review of medical cases, compliance with regulations, and efficient coordination between providers, payers, and patients.

What does a utilization management coordinator do?

A Utilization Management Coordinator is responsible for reviewing and assessing healthcare services to ensure that patients receive appropriate care while managing costs for healthcare providers or insurance companies. They evaluate medical records, coordinate with healthcare professionals, and help determine if certain treatments or procedures are medically necessary according to established guidelines. Their goal is to optimize the use of healthcare resources, prevent unnecessary treatments, and support quality patient outcomes.

How does a utilization management coordinator typically collaborate with clinical staff and insurance providers?

A Utilization Management Coordinator serves as a vital link between healthcare providers, clinical staff, and insurance companies. They regularly communicate with physicians and nurses to gather clinical information, review treatment plans, and ensure that proposed services meet medical necessity criteria. Coordinators also interact with insurance providers to obtain pre-authorizations, clarify coverage policies, and appeal denied claims when appropriate. Effective collaboration and strong communication skills are essential, as the role requires balancing the needs of patients, providers, and payers while ensuring timely and cost-effective care.

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 are popular job titles related to Utilization Management Coordinator jobs in Virginia?

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

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

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

What cities in Virginia are hiring for Utilization Management Coordinator jobs?

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

Utilization Management Coordinator jobs near you
Infographic showing various Utilization Management Coordinator job openings in Virginia as of August 2026, with employment types broken down into 1% As Needed, 84% Full Time, 13% Part Time, and 2% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $61,057 per year, or $29.4 per hour.

Utilization Management Nurse Consultant

CVS Health

Richmond, VA • On-site

$26.01 - $68.55/hr

Other

Medical, Dental, Vision, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

CVS Health rating

5.8

Company rating: 5.8 out of 10

Based on 4,335 frontline employees who took The Breakroom Quiz

89th of 112 rated pharmacies

Job description

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and evening hours.

Schedule

Fully Remote- WFH

M-F 8A-5P EST/9A-6P CST with 1 hour lunch

Position Summary

Position Summary:

UM Nurse Consultant

Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.

Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation along the continuum of care. Communicates with providers and other parties to facilitate care/treatment Identifies members for referral opportunities to integrate with other products, services and/or programs Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function.

Required Qualifications

3+ years of experience as an RN

Active and unrestricted RN licensure in state of residence

Able to work in multiple IT platforms/systems

1+ years of experience with Microsoft Office Applications (Outlook, Teams, Excel)

Preferred Qualifications

Prior authorization utilization experience preferred

Outpatient Clinical experience

Knowledge of Medicare/Medicaid

Managed care experience

Education

Associates Degree in Nursing required

BSN preferred

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$26.01 - $68.55

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments (https://learn.bswift.com/cvshealth-mainland) .

We anticipate the application window for this opening will close on: 08/12/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran - committed to diversity in the workplace.

What CVS Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply