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Utilization Management Coordinator Jobs in Reston, VA

Inova

Registered Nurse (RN) Case Manager 2

Fairfax, VA · On-site

$92K - $151K/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

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How much do utilization management coordinator jobs pay per hour?

As of Aug 16, 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?

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:

What job categories do people searching Utilization Management Coordinator jobs in Reston, VA look for?

The top searched job categories for Utilization Management Coordinator jobs in Reston, VA are:

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 August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 16% Part Time, and 2% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $64,070 per year, or $30.8 per hour.

Social Work Manager Case Management

MedStar Health

Washington, DC • On-site

$102K - $196K/yr

Full-time

Posted 20 days ago

Medstar Health rating

7.8

Company rating: 7.8 out of 10

Based on 239 frontline employees who took The Breakroom Quiz

129th of 887 rated healthcare providers

Job description

About the Job
General Summary of Position
MedStar Health is looking for a Social Work Manager, Case Management. The Social Work Manager, Case Management Reports and works under the direction of the Director of Case Management. Provides leadership for the case management team and oversees the Department's daily activities. Coordinates the department's case management/utilization functions to provide efficient and effective outcome-based patient centered care. Primary responsibilities include, but are not limited to, assigning duties to staff members based on ratios/volumes, skills, and departmental needs, identifying and mitigating problems as they occur, and addressing performance issues. Demonstrates the ability to meet the needs and provide service to all age groups.
Join one of the largest healthcare systems in the Baltimore-Washington metro region, also recognized as one of the "Healthiest Maryland Businesses". Apply today and learn how MedStar Health can be your next great career move!
Primary Duties:
  • Leads and supervises the Case Management team, including recruitment, onboarding, orientation, training, competency assessments, performance evaluations, and ongoing professional development for social work staff.
  • Oversees daily department operations by managing staffing, patient census, case assignments, and workflow to ensure efficient care coordination, utilization management, discharge planning, and resource allocation.
  • Supports the strategic and operational direction of the Case Management program by integrating social work, utilization management, and case management services, monitoring key performance indicators, managing departmental budgets, and driving quality improvement initiatives.
  • Collaborates with physicians, clinical leadership, regulatory agencies, and community partners to address medical necessity, denials management, documentation, post-acute care planning, compliance, and complex patient care needs while escalating high-risk issues appropriately.
  • Represents the department through multidisciplinary committees, community outreach, and partnerships with internal and external stakeholders to enhance patient outcomes, regulatory compliance, and operational excellence.

Qualifications:
  • Master's Degree (Required)
  • 3-4 years of relevant acute care work experience (Required)
  • 2-3 years of Case Management or Social Work experience (Preferred)
  • 2-3 years of progressive leadership experience

Licenses/Certifications:
• LGSW - Licensed Graduate Social Worker with independent license within one year of hire (Required)
• LMSW - Licensed Master Social Worker - State Licensure 3-4 years of relevant acute care work experience with independent license within one year of hire (Required)
• LCSW-C - Licensed Certified Social Worker - Clinical-3 years of Case Management or Social Work experience (Required)
• LICSW - Licensed Independent Clinical Social Worker (Required)
  • CCM - Certified Case Manager from a nationally recognized certification agency (Preferred)

This position has a hiring range of
USD $102,606.00 - USD $196,996.00 /Yr.

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About Medstar Health

Sourced by ZipRecruiter

MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation, and research. Our team of 32,000 includes physicians, nurses, residents, fellows, and many other clinical and non-clinical associates working in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest home health provider in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar Health is dedicated not only to teaching the next generation of doctors, but also to the continuing education, professional development, and personal fulfillment of our whole team. Together, we use the best of our minds and the best of our hearts to serve our patients, those who care for them, and our communities. It's how we treat people.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Columbia, MD, US

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