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Utilization Manager Jobs in Virginia (NOW HIRING)

Summit BHC

Utilization Specialist

Williamsburg, VA · On-site

Coordinates, performs, and monitors all utilization review/management activities of the hospital to continuously improve the collection, reimbursement, coordination, and presentation of utilization ...

Humana

Utilization Management RN

Richmond, VA · On-site

This role will report directly to the Manager, Utilization Management. Key Responsibilities: Clinical Review: · Conduct comprehensive clinical reviews of prior authorization requests to determine ...

Summit BHC

Utilization Specialist - Acute

Williamsburg, VA · On-site

$24 - $28/hr

Coordinates, performs, and monitors all utilization review/management activities of the hospital to continuously improve the collection, reimbursement, coordination, and presentation of utilization ...

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All JobsUtilization JobsUtilization Manager JobsUtilization Manager Jobs in Virginia

Utilization Manager information

See Virginia salary details

$38.7K

$90.2K

$166.1K

How much do utilization manager jobs pay per year?

As of Aug 10, 2026, the average yearly pay for utilization manager in Virginia is $90,231.00, according to ZipRecruiter salary data. Most workers in this role earn between $59,000.00 and $108,600.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a utilization manager?

To thrive as a Utilization Manager, you need a solid background in healthcare management, case review, and knowledge of insurance regulations, often supported by a degree in nursing, healthcare administration, or a related field. Familiarity with utilization management software, electronic health records (EHRs), and certification such as Certified Case Manager (CCM) are typically required. Strong analytical thinking, communication, and negotiation skills help Utilization Managers effectively coordinate care and collaborate with providers. These skills ensure appropriate resource use, regulatory compliance, and optimal patient outcomes within healthcare organizations.

What are some common challenges faced by utilization managers, and how can they be addressed?

Utilization Managers often face challenges such as balancing cost containment with patient care quality, navigating complex insurance policies, and managing high caseloads. To address these, effective communication with healthcare providers and payers is essential, as is staying current with regulatory requirements and best practices. Building strong relationships within interdisciplinary teams and leveraging data analytics tools can also help Utilization Managers make informed decisions and improve workflow efficiency.

What is a utilization manager?

A utilization manager works in the insurance industry to analyze health care needs in medical cases and determine further patient care. In this career, your job duties include conducting interviews to determine what services you register for and cutting down on unnecessary costs. You may review medical records and compile documentation to improve care and report your findings. Skills in management, customer service, and health care services are vital in this career. Job experience in nursing is a benefit when applying for utilization manager positions. Additional qualifications include a bachelor’s degree and medical case management certificate.

What is the difference between Utilization Manager vs Utilization Coordinator?

AspectUtilization ManagerUtilization Coordinator
CertificationsOften requires healthcare or case management certificationsMay have similar certifications but less emphasis on management
Work EnvironmentTypically in healthcare organizations, overseeing utilization review processesSupports daily operations, assisting with case documentation and scheduling
Employer & Industry UsageCommon in healthcare, insurance, and managed care companiesFound in similar settings, often working under Utilization Managers

In summary, a Utilization Manager generally has broader responsibilities, overseeing utilization review and resource allocation, while a Utilization Coordinator focuses on supporting daily tasks and documentation. Both roles are integral in healthcare settings but differ in scope and level of responsibility.

More about Utilization Manager jobs
What are the most commonly searched types of Utilization jobs in Virginia? The most popular types of Utilization jobs in Virginia are:
What are popular job titles related to Utilization Manager jobs in Virginia? For Utilization Manager jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Utilization Manager jobs in Virginia look for? The top searched job categories for Utilization Manager jobs in Virginia are:
What cities in Virginia are hiring for Utilization Manager jobs? Cities in Virginia with the most Utilization Manager job openings:
What are popular job titles related to Utilization Manager jobs in VA? For Utilization Manager jobs in VA, the most frequently searched job titles are:
Utilization Manager jobs near you
Infographic showing various Utilization Manager job openings in Virginia as of August 2026, with employment types broken down into 100% Full Time. Highlights an 80% In-person, and 20% Remote job distribution, with an average salary of $90,231 per year, or $43.4 per hour.

Clinical Nurse - Utilization Manager

Saratoga Medical Center

Falls Church, VA • On-site

Full-time

Medical, PTO

Re-posted 23 hours 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.