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Utilization Management Jobs in Virginia (NOW HIRING)

UHS

UTILIZATION COORDINATOR

Danville, VA · On-site

... managing timely transitions through the phases of residential care. Key Responsibilities: · Facilitates communication regarding resident treatment process and needs with referral sources and payor ...

Lthc

Medical Director, Commercial

Jamestown, VA · On-site

Reviews and makes recommendations and/or decisions on Utilization or Case Management activities. Utilization review activities include: reviews of requests for broad range of medical services ...

Evolent

Radiology Physician

Arlington, VA

$368K - $460K/yr

As a FMD, Radiology you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients lives, in a non-clinical environment. You can enjoy ...

Lthc

Medical Director, Commercial

Jamestown, VA · On-site

Reviews and makes recommendations and/or decisions on Utilization or Case Management activities. Utilization review activities include: reviews of requests for broad range of medical services ...

Lthc

Medical Director, Commercial

Jamestown, VA · On-site

Reviews and makes recommendations and/or decisions on Utilization or Case Management activities. Utilization review activities include: reviews of requests for broad range of medical services ...

Evolent

Internal Medicine Physician

Arlington, VA

As a FMD, Radiology, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients lives, in a non-clinical environment. You can ...

Elevance Health

Medical Management Specialist I

Norfolk, VA · On-site

$19.66 - $31.04/hr

Responsibilities exclude conducting any utilization management review activities which require interpretation of clinical information. Minimum Requirements: * Requires a H.S. diploma or equivalent ...

Elevance Health

Medical Management Specialist I

Norfolk, VA · On-site

$19.66 - $31.04/hr

Responsibilities exclude conducting any utilization management review activities which require interpretation of clinical information. Minimum Requirements: * Requires a H.S. diploma or equivalent ...

Elevance Health

Medical Management Specialist I

Roanoke, VA · On-site

$19.66 - $31.04/hr

Responsibilities exclude conducting any utilization management review activities which require interpretation of clinical information. Minimum Requirements: * Requires a H.S. diploma or equivalent ...

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All JobsUtilization Management JobsUtilization Management Jobs in Virginia

Utilization Management information

See Virginia salary details

$38.7K

$88.7K

$161.6K

How much do utilization management jobs pay per year?

As of Jul 15, 2026, the average yearly pay for utilization management in Virginia is $88,715.00, according to ZipRecruiter salary data. Most workers in this role earn between $63,900.00 and $103,600.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in the Utilization Management position, and why are they important?

To thrive in Utilization Management, you need a strong understanding of healthcare procedures, insurance guidelines, and case review processes, usually backed by a clinical background such as RN, LPN, or allied health certification. Familiarity with medical management software, electronic health records (EHR), and utilization review tools like InterQual or MCG is often required. Excellent analytical thinking, attention to detail, and effective communication skills greatly enhance performance in this role. These competencies enable accurate assessment of medical necessity, ensure regulatory compliance, and support efficient, collaborative workflows between providers, insurers, and patients.

What is a Utilization Management job?

A Utilization Management (UM) job involves evaluating medical services to ensure they are necessary, cost-effective, and compliant with healthcare guidelines. Professionals in this field review patient care plans, authorize treatments, and collaborate with healthcare providers to optimize resource use. They work for insurance companies, hospitals, or healthcare organizations to balance quality care with cost control. Strong analytical skills and knowledge of medical policies are essential in this role.

What are the typical daily responsibilities of a Utilization Management professional?

As a Utilization Management professional, your day-to-day duties typically include reviewing patient admissions, authorizing ongoing treatment or procedures, assessing medical necessity, and ensuring services comply with insurance policies and industry guidelines. You will frequently collaborate with physicians, nurses, and insurance representatives to facilitate timely and appropriate care decisions while managing cost and quality. Documentation and communication play key roles as you help bridge the gap between clinical teams and payers. This role is often fast-paced, requires decisive action, and provides opportunities to have a direct impact on patient outcomes and organizational efficiency.

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 jobs in Virginia? For Utilization Management jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Utilization Management jobs in Virginia look for? The top searched job categories for Utilization Management jobs in Virginia are:
What cities in Virginia are hiring for Utilization Management jobs? Cities in Virginia with the most Utilization Management job openings:
Utilization Management jobs near you
Infographic showing various Utilization Management job openings in Virginia as of July 2026, with employment types broken down into 1% As Needed, 82% Full Time, 14% Part Time, 1% Temporary, and 2% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $88,715 per year, or $42.7 per hour.
Supervisor, MSW, Inpatient Case Management

Supervisor, MSW, Inpatient Case Management

Sentara Healthcare

Norfolk, VA • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 15 days ago

Sentara Health rating

6.9

Company rating: 6.9 out of 10

Based on 391 frontline employees who took The Breakroom Quiz

449th of 885 rated healthcare providers

Job description

City/State
Norfolk, VA
Work Shift
First (Days)
Overview:
Sentara Norfolk General Hospital is hiring a Supervisor, MSW, Inpatient Case Management.
This is a full-time 40 hour per week position.
Requirements:
-Master's Degree in Social Work (MSW)
-Licensed LMFT, LPC, LCSW or LPC
-3 years clinical experience
-3 years related experience
-prior supervisory experience
The Supervisor, MSW, Inpatient Case Management assumes responsibility, accountability and leadership for the daily operations including coordination
of work, quality, and service. First line supervisor in the Utilization Management Department. Facilitates the work of assigned team members. Provides a leadership role in ongoing utilization review competency assessment, needs identification and educational offerings. Provides educational services to the Utilization Management staff. Participates in the work activities of assigned teams. Responsible for review of clinical information received from providers ensuring clinical data is substantial enough to meet Medical Necessity Criteria to authorize services as needed. Requires knowledge of managed care contracting, Medical Necessity, CMHRS services, DMAS protocols, clinical protocols and clinical review requirements. Requires knowledge of contractual, regulatory and compliance requirements for government payers, self funded and commercial payers. Ensures appropriate and accurate information is entered into claims system for processing of payment.
keywords, Supervisor, Case Management, MSW, Social Worker, LCSW, LMFT,. LPC
Benefits: Caring For Your Family and Your Career
• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to 10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance - 5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down - 10,000
• Reimbursement for certifications and free access to complete CEUs and professional development
• Pet Insurance
• Legal Resources Plan
• Colleagues may have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met
Here at Sentara, we are committed to consistently enhancing our training, advancement tracks, work-life benefits, and more. Our goal is to make you feel more excited to be here every day!
Sentara Norfolk General Hospital, located in Norfolk, VA, is a 525-bed tertiary care facility that is home to the only Level I Adult Trauma Center and burn trauma unit in Hampton Roads, and also serves as the primary teaching hospital for Eastern Virginia Medical School.
In addition to the high-quality heart program at Sentara Heart Hospital, our facility is home to Nightingale Regional Air Ambulance and several other dedicated facilities and specialized services. As a recognized accredited Comprehensive Stroke Center, and Magnet hospital for nursing excellence, our hospital specializes in heart and vascular, neurosciences, neurosurgery, urology, oncology, spine care, advanced imaging, behavioral health, maternity, and women's health, including a state-of-the-art neonatal intensive care unit.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission "to improve health every day," this is a tobacco-free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

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