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Utilization Management Jobs in Washington, DC (NOW HIRING)

MedStar Health

Director Case Management

Columbia, MD · On-site

The Director of Case Management (DCM) oversees case management activities that may include behavioral health utilization management and care management functions and serves as a liaison to government ...

Decypher

Registered Nurse Case Manager

Bethesda, MD

$40 - $50/hr

Experience in Referral Management/Utilization Management (RM/UM). * Two to five years of current clinical subspecialty experience in Behavioral Health. * Knowledge of sources for patient care data ...

New

Decypher

Registered Nurse Case Manager

Bethesda, MD · On-site

$40 - $50/hr

Experience in Referral Management/Utilization Management (RM/UM). * Two to five years of current clinical subspecialty experience in Behavioral Health. * Knowledge of sources for patient care data ...

New

Decypher

Registered Nurse Case Manager

Bethesda, MD · On-site

$40 - $50/hr

Experience in Referral Management/Utilization Management (RM/UM). * Two to five years of current clinical subspecialty experience in Behavioral Health. * Knowledge of sources for patient care data ...

New

Decypher

Registered Nurse - Case Manager

Bethesda, MD

$40 - $50/hr

Experience in Referral Management/Utilization Management (RM/UM). * Two to five years of current clinical subspecialty experience in Behavioral Health. * Knowledge of sources for patient care data ...

New

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Showing results 21-40

All JobsUtilization Management JobsUtilization Management Jobs in Washington, DC

Utilization Management information

See Washington, DC salary details

$44.2K

$101.3K

$184.6K

How much do utilization management jobs pay per year?

As of Sep 6, 2026, the average yearly pay for utilization management in Washington, DC is $101,348.00, according to ZipRecruiter salary data. Most workers in this role earn between $73,100.00 and $118,400.00 per year, depending on experience, location, and employer.

What is utilization management?

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 key skills and qualifications needed to thrive in utilization management, 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 degree is needed for utilization management?

Utilization management professionals typically need at least a bachelor's degree in healthcare, nursing, health administration, or a related field. Some roles may require a master's degree or professional certifications such as Certified Professional in Healthcare Quality (CPHQ) or Certified Case Manager (CCM). Experience in healthcare settings and knowledge of medical terminology and insurance processes are also important.

What are the most commonly searched types of Utilization Management jobs in Washington, DC?

The most popular types of Utilization Management jobs in Washington, DC are:

What are popular job titles related to Utilization Management jobs in Washington, DC?

For Utilization Management jobs in Washington, DC, the most frequently searched job titles are:

What job categories do people searching Utilization Management jobs in Washington, DC look for?

The top searched job categories for Utilization Management jobs in Washington, DC are:

Utilization Management jobs near you
Infographic showing various Utilization Management job openings in Washington, DC as of August 2026, with employment types broken down into 100% Full Time. Highlights an 86% In-person, and 14% Remote job distribution, with an average salary of $101,348 per year, or $48.7 per hour.

Clinical Nurse - Utilization Manager

Saratoga Medical Center

Falls Church, VA • On-site

Full-time

Medical, PTO

Re-posted 27 days ago

Job description

Saratoga Medical is hiring for a Clinical Nurse, Medical Management/Utilization Management in Falls Church, Virginia. Package includes competitive rate, paid time off and benefit options.

This is a great full-time opportunity with telework available. Please see the qualifications below and submit your resume if you are interested in being considered. 


Required Qualifications:

  • Bachelor's degree in Nursing, Master's preferred, or other clinically related Health Service degree. 
  • Department of Defense Program Management (PM) experience preferred, minimum 2 years within the last 5 years. 
  • Experience in the operations and organization of the Department of Defense Military Health System desired. 





Saratoga Medical Center, Inc. is an equal opportunity employer and will not discriminate in recruiting, hiring, training, promotion, transfer, discharge, compensation or any other term or condition of employment on the basis of race, religion, color, age (over age 39), sex, national origin, or on the basis of disability if the employee can perform the essential functions of the job, with a reasonable accommodation if necessary.