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Utilization Management Coordinator Jobs in Virginia

Inova

Registered Nurse (RN) Case Manager

Alexandria, VA · On-site

$86K - $140K/yr

Provides coordination of services and acts as key liaison between patients, families and interdisciplinary healthcare members. Uses utilization management techniques to determine the medical ...

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Utilization Management Coordinator information

See Virginia salary details

$15

$29

$46

How much do utilization management coordinator jobs pay per hour?

As of Sep 6, 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 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.

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.

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 degree do you need for utilization management coordinator?

A utilization management coordinator typically needs at least a bachelor's degree in healthcare administration, nursing, or a related field. Relevant certifications, such as Certified Professional in Healthcare Quality (CPHQ), can enhance job prospects. Strong knowledge of medical terminology, insurance processes, and data analysis tools is also important.

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, 77% Full Time, 20% Part Time, and 2% Contract. Highlights an 84% Physical, 3% Hybrid, and 13% Remote job distribution, with an average salary of $61,057 per year, or $29.4 per hour.

Medical Director Physician

Sentara Health

Williamsburg, VA • On-site

Full-time

Posted 9 days ago

Sentara Health rating

6.8

Company rating: 6.8 out of 10

Based on 417 frontline employees who took The Breakroom Quiz

497th of 898 rated healthcare providers

Job description

Overview

Reporting to the division president and as a member of the division leadership team, the VP, Chief Medical Officer is accountable for the clinical performance improvement including the promotion of clinical appropriateness, the reduction of unwarranted clinical variation, clinical resource and outcomes management, coordinated oversight of hospitalists, and patient safety/quality related activities of the hospital.

Sentara Williamsburg Regional Medical Center is a 145-bed facility featuring the latest healthcare technologies, serving Williamsburg and the surrounding community. The hospital is a Certified Primary Stroke Center and STEMI Center and offers a full range of medical care from emergency heart catheterization to all-inclusive maternity care where patients may stay in one room, as well as a Gold Level Geriatric ER. Sentara Williamsburg Regional Medical Center provides advanced imaging and "smart" operating rooms. The hospital has achieved Magnet recognition, the nation's high honor for excellence in nursing. It is one of the few hospitals in the nation that has achieved a consecutive Leapfrog A safety rating.

Williamsburg VA, is known for its colonial history and for being the home of the world's largest living history museum. English settlers founded the city as Middle Plantation in 1632, and it existed as the capital of the Virginia Colony from 1699 to 1780. It's named after King William III of England. Today, Williamsburg is a great place to live for families, retirees, and anyone seeking a peaceful small town with modern amenities and historical significance.

Education

  • Medical Doctor (MD) - State License - Virginia Department of Health Professionals (VADHP)
  • Board certification in specialty required at time of hire, preferred ongoing recertification. Accreditation/Regulatory Standards, Infection Prevention and Control, Clinical Service Line Development, Utilization Review/Utilization Management, Clinical Standardization, Clinical Informatics, Clinical Integration, Human Relations, Employee Health, Risk Management, Research/IRB, Patient Experience, Physician contracts and recruiting, alternative payment models, and functions as liaison to appropriate leadership in Sentara Medical Group and surrounding Patient-Centered Medical Homes. Function as Administrator-on-call for hospital. Understanding of Lean/Six Sigma methodologies. Understanding of role as executive sponsor for projects and RCAs, and project leadership for system responsibilities. Involved with marketing, population health strategies, participates in key strategy discussions. Understands laws and other legal decisions such as HIPAA, HCQIA and the HITECH ACT

Experience

  • 5 years of clinical practice experience required.
  • 5 years of leadership experience preferred in an acute care, inpatient hospital setting. Knowledgeable of contemporary practice issues within medicine, and outcomes measurement of clinical quality and utilization. Must be familiar with all aspects of hospital operations. Leadership in areas of Patient Safety/Quality, Medical Staff Affairs

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