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Utilization Management Coordinator Jobs in Reston, VA

Luminis Health

Utilization Management Nurse

Lanham, MD

$34 - $55/hr

Provides intervention and coordination to decrease avoidable delays and denial of payment ... Monitors and identifies patterns or trends in utilization management; monitors potential and actual ...

UHS

Utilization Review Coordinator

Washington, DC · On-site

$33.60 - $50.40/hr

Informs department director of changes in managed care companies. Maintains awareness of unique ... Six months psychiatric utilization review either for hospital or external review organization ...

UHS

Utilization Review Coordinator

Washington, DC

Informs department director of changes in managed care companies. Maintains awareness of unique ... Six months psychiatric utilization review either for hospital or external review organization ...

UHS

Utilization Review Coordinator

Washington, DC

Informs department director of changes in managed care companies. Maintains awareness of unique ... Six months psychiatric utilization review either for hospital or external review organization ...

Compass Group

SPACE UTILIZATION COORDINATOR

Mclean, VA · On-site

$55K - $62K/yr

As the Space Utilization Coordinator, you'll oversee meeting space reservations, ensuring optimal ... Manage and assign meeting spaces based on availability and event needs. * Audit reservations to ...

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Utilization Management Coordinator information

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$48

How much do utilization management coordinator jobs pay per hour?

As of Jul 26, 2026, the average hourly pay for utilization management coordinator in Reston, VA is $30.80, according to ZipRecruiter salary data. Most workers in this role earn between $22.26 and $36.01 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Utilization Management Coordinator, and why are they important?

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 Reston, VA? The most popular types of Utilization Management jobs in Reston, VA are:
What are popular job titles related to Utilization Management Coordinator jobs in Reston, VA? For Utilization Management Coordinator jobs in Reston, VA, the most frequently searched job titles are:
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What cities near Reston, VA are hiring for Utilization Management Coordinator jobs? Cities near Reston, VA with the most Utilization Management Coordinator job openings:
Utilization Management Coordinator jobs near you
Infographic showing various Utilization Management Coordinator job openings in Reston, VA as of July 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $64,070 per year, or $30.8 per hour.
Utilization Management Nurse

Utilization Management Nurse

Luminis Health

Lanham, MD

$34 - $55/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 12 days ago

Luminis Health rating

8.1

Company rating: 8.1 out of 10

Based on 52 frontline employees who took The Breakroom Quiz

68th of 890 rated healthcare providers

Job description

Position Objective:  Conducts concurrent and retrospective chart review for clinical, financial, and resource utilization information. Provides intervention and coordination to decrease avoidable delays and denial of payment.  

Essential Job Duties:

1. Chart Review:

Reviews the medical record by applying utilization review criteria, to assess clinical, financial, and resource utilization; enters clinical review in EPIC; maintains close communication with external reviews, care coordinators, and providers; reconciles and records days authorized in EPIC

2. Denial Management:

Monitors and identifies patterns or trends in utilization management; monitors potential and actual denials and collaborates with care coordinator for any follow up necessary; documents actions taken to avoid denial;  assists Care Coordinator in communicating with the patient denied hospital days with work toward resolution and discharge.

3. Care Coordination:

Collaborates with the Care Coordinator to achieve optimal and efficient patient outcomes while decreasing length of stay, avoidable delays and denied days; utilizes Physician Advisor and administrative personnel for unresolved issues; identifies opportunities for expedited appeals and collaborates with the care coordinator and Physician Advisor to resolve payer issues.

4.  Process improvement initiatives

Participates in nursing unit and department clinical outcome projects as well as process improvement initiatives of care management.

Educational/Experience Requirements:

  • Bachelor’s of Science in Nursing or Associate’s degree in Nursing with equivalent experience.  BSN must be achieved within 5 years of start date in the role.  
  • Three years of clinical nursing in an acute care hospital setting.

RequiredLicense/Certifications:

  • Current RN license from Maryland Board of Nursing.

Working Conditions, Equipment, Physical Demands:

There is a reasonable expectation that employees in this position will be exposed to blood-borne pathogens.

Physical Demands -

The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act.

The above job description is an overview of the functions and requirements for this position.  This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.

Pay Range
$34—$55 USD

Luminis Health Benefits Overview:
•    Medical, Dental, and Vision Insurance
•    Retirement Plan (with employer match for employees who work more than 1000 hours in a calendar year)
•    Paid Time Off
•    Tuition Assistance Benefits
•    Employee Referral Bonus Program
•    Paid Holidays, Disability, and Life/AD&D for full-time employees
•    Wellness Programs
•    Employee Assistance Programs and more
*Benefit offerings based on employment status

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