Utilization Assistant
Williamsburg, VA · On-site
The Utilization Assistant provides support to all utilization review/management activities of the hospital to continuously improve the collection, reimbursement, coordination, and presentation of ...
Utilization Assistant
Williamsburg, VA · On-site
The Utilization Assistant provides support to all utilization review/management activities of the hospital to continuously improve the collection, reimbursement, coordination, and presentation of ...
In this position, you will ensure all utilization management and training processes are completed as needed to ensure quality services are provided. While working for NRVCS, you are subject to our ...
In this position, you will ensure all utilization management and training processes are completed as needed to ensure quality services are provided. While working for NRVCS, you are subject to our ...
In this position, you will ensure all utilization management and training processes are completed as needed to ensure quality services are provided. While working for NRVCS, you are subject to our ...
In this position, you will ensure all utilization management and training processes are completed as needed to ensure quality services are provided. While working for NRVCS, you are subject to our ...
Utilization Management Representative I
Norfolk, VA · On-site
$36K - $41K/yr
Utilization Management Representative I Utilization Management Representative I Location : This ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
Utilization Management Representative I
Norfolk, VA · On-site
$36K - $41K/yr
Utilization Management Representative I Utilization Management Representative I Location : This ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
Utilization Management Representative I
Roanoke, VA · On-site
$36K - $42K/yr
Utilization Management Representative I Utilization Management Representative I Location : This ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
Utilization Management Representative I
Roanoke, VA · On-site
$36K - $42K/yr
Utilization Management Representative I Utilization Management Representative I Location : This ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
Utilization Management Representative I
Richmond, VA · On-site
$37K - $42K/yr
Utilization Management Representative I Utilization Management Representative I Location : This ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
Utilization Management Representative I
Richmond, VA · On-site
$37K - $42K/yr
Utilization Management Representative I Utilization Management Representative I Location : This ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
... managing timely transitions through the phases of residential care. Key Responsibilities: · Facilitates communication regarding resident treatment process and needs with referral sources and payor ...
... managing timely transitions through the phases of residential care. Key Responsibilities: · Facilitates communication regarding resident treatment process and needs with referral sources and payor ...
Prefers minimum two years of Utilization Review/Management, Quality Assurance or Risk Management. Knowledge of DMAS regulations and experience in Acentra/Kepro and Humana/Tricare portal is highly ...
Prefers minimum two years of Utilization Review/Management, Quality Assurance or Risk Management. Knowledge of DMAS regulations and experience in Acentra/Kepro and Humana/Tricare portal is highly ...
Prefers minimum two years of Utilization Review/Management, Quality Assurance or Risk Management. Knowledge of DMAS regulations and experience in Acentra/Kepro and Humana/Tricare portal is highly ...
Prefers minimum two years of Utilization Review/Management, Quality Assurance or Risk Management. Knowledge of DMAS regulations and experience in Acentra/Kepro and Humana/Tricare portal is highly ...
Utilization Management Representative I
Norfolk, VA · On-site
$32K - $37K/yr
Utilization Management Representative I Location : This role enables associates to work virtually ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
Utilization Management Representative I
Norfolk, VA · On-site
$32K - $37K/yr
Utilization Management Representative I Location : This role enables associates to work virtually ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
Utilization Management Representative I
Roanoke, VA · On-site
$36K - $42K/yr
Utilization Management Representative I Location : This role enables associates to work virtually ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
Utilization Management Representative I
Roanoke, VA · On-site
$36K - $42K/yr
Utilization Management Representative I Location : This role enables associates to work virtually ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
Utilization Management Representative I
Richmond, VA · On-site
$37K - $42K/yr
Utilization Management Representative I Location : This role enables associates to work virtually ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
Utilization Management Representative I
Richmond, VA · On-site
$37K - $42K/yr
Utilization Management Representative I Location : This role enables associates to work virtually ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
Utilization Review * Interdisciplinary Care Management * Epic EMR experience required * Strong communication and organizational skills Key Responsibilities * Coordinate patient care throughout ...
Utilization Review * Interdisciplinary Care Management * Epic EMR experience required * Strong communication and organizational skills Key Responsibilities * Coordinate patient care throughout ...
Nurse Case Mgr II
$71K - $130K/yr
Supports patient safety, utilization management, and quality improvement initiatives through identification of trends, opportunities, and interventions to improve outcomes and reduce preventable harm.
Nurse Case Mgr II
$71K - $130K/yr
Supports patient safety, utilization management, and quality improvement initiatives through identification of trends, opportunities, and interventions to improve outcomes and reduce preventable harm.
Nurse Case Mgr II
Norfolk, VA · On-site
$71K - $130K/yr
Supports patient safety, utilization management, and quality improvement initiatives through identification of trends, opportunities, and interventions to improve outcomes and reduce preventable harm.
Nurse Case Mgr II
Norfolk, VA · On-site
$71K - $130K/yr
Supports patient safety, utilization management, and quality improvement initiatives through identification of trends, opportunities, and interventions to improve outcomes and reduce preventable harm.
Nurse Case Mgr II
Norfolk, VA · On-site
$71K - $130K/yr
Supports patient safety, utilization management, and quality improvement initiatives through identification of trends, opportunities, and interventions to improve outcomes and reduce preventable harm.
Nurse Case Mgr II
Norfolk, VA · On-site
$71K - $130K/yr
Supports patient safety, utilization management, and quality improvement initiatives through identification of trends, opportunities, and interventions to improve outcomes and reduce preventable harm.
The Utilization Review Advisor (Advisor) position conducts timely and compliant medical necessity reviews and assists with denials management (facilitating and completing peer to peers, writing ...
The Utilization Review Advisor (Advisor) position conducts timely and compliant medical necessity reviews and assists with denials management (facilitating and completing peer to peers, writing ...
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 ...
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 ...
Uses utilization management techniques to determine the medical necessity, appropriateness and efficiency of the use of healthcare services, procedures and facilities. Responsible for the timely ...
Uses utilization management techniques to determine the medical necessity, appropriateness and efficiency of the use of healthcare services, procedures and facilities. Responsible for the timely ...
Uses utilization management techniques to determine the medical necessity, appropriateness and efficiency of the use of healthcare services, procedures and facilities. Responsible for the timely ...
Uses utilization management techniques to determine the medical necessity, appropriateness and efficiency of the use of healthcare services, procedures and facilities. Responsible for the timely ...
Utilization Manager information
See Virginia salary details
$38.7K - $50.2K
9% of jobs
$58.8K is the 25th percentile. Wages below this are outliers.
$50.2K - $61.8K
22% of jobs
$61.8K - $73.4K
11% of jobs
The median wage is $80.5K / yr.
$73.4K - $85K
14% of jobs
$85K - $96.6K
12% of jobs
$103.8K is the 75th percentile. Wages above this are outliers.
$96.6K - $108.2K
13% of jobs
$108.2K - $119.7K
13% of jobs
$119.7K - $131.3K
5% of jobs
$131.3K - $142.9K
2% of jobs
$142.9K - $154.5K
0% of jobs
$154.5K - $166.1K
0% of jobs
$38.7K
$90.2K
$166.1K
How much do utilization manager jobs pay per year?
As of Jun 29, 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 jobs pay $2000 a day?
Utilization Managers typically do not earn $2000 a day; such high daily rates are more common in specialized consulting, executive roles, or highly experienced professionals in fields like finance, law, or certain medical specialties. These roles often require advanced certifications, extensive experience, and work in high-demand environments. Most standard utilization management positions offer salaries that are significantly lower than this daily rate.
What job makes $10,000 a month without a degree?
A Utilization Manager can potentially earn $10,000 or more per month through experience and advanced skills in healthcare or corporate settings, often without a formal degree. Success in such roles depends on industry knowledge, certifications, and the ability to optimize resource use, with some professionals reaching high earnings through management of large teams or projects.
What jobs in the US pay 300,000 a year?
Utilization Managers in healthcare and insurance industries can earn around $300,000 annually, especially with extensive experience, certifications, and leadership responsibilities. High-paying roles often require advanced skills in data analysis, resource allocation, and strategic planning, and may involve managing large teams or complex projects.
What does a utilization manager do?
A utilization manager oversees the efficient use of resources, such as staff and equipment, to ensure that services are delivered within budget and meet organizational goals. They analyze data, monitor utilization rates, and coordinate with teams to optimize productivity and reduce waste, often using management software and reporting tools.
What are the key skills and qualifications needed to thrive as a Utilization Manager, and why are they important?
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?
| Aspect | Utilization Manager | Utilization Coordinator |
|---|---|---|
| Certifications | Often requires healthcare or case management certifications | May have similar certifications but less emphasis on management |
| Work Environment | Typically in healthcare organizations, overseeing utilization review processes | Supports daily operations, assisting with case documentation and scheduling |
| Employer & Industry Usage | Common in healthcare, insurance, and managed care companies | Found 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:
- Assistant Remote Utilization Review
- Director Of Utilization Review
- Chart Review Nurse Practitioner
- Aetna Utilization Review Nurse
- Manager Aetna Utilization Review
- Full Time Bcba Utilization Review
- Utilization Care Manager
- Live In Cigna Utilization Review Nurse
- Temporary Medical Utilization Review Physician
- Free Utilization Review Training
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:
Key responsibilities
Assists the admissions department with pre-certifications of care and performs pre and post admission benefit verification with managed care organizations.
Reviews medical records of patients for appropriateness of level of care at admission and at intervals determined by documentation in medical record.
Conducts interactive and timely reviews with payers to ensure certification of care and maintains accurate documentation and files related to utilization management.
Job description
Utilization Assistant | The Pavilion at Williamsburg Place | Williamsburg, Virginia
About the Job:
The Utilization Assistant provides support to all utilization review/management activities of the hospital to continuously improve the collection, reimbursement, coordination, and presentation of utilization review information. Works with insurance providers to obtain coverage for patients. Assists in utilization reviews and insurance appeals. Responds to inquiries from patients, their families, and professional referral sources.
Roles and Responsibilities:
• Assists the admissions department with pre-certifications of care. Performs pre and post admission benefit verification with managed care organizations.
• Reviews medical records of patients for appropriateness of level of care at admission and at intervals determined by documentation in medical record.
• Conducts interactive and timely reviews with payers to ensure certification of care.
• Maintains accurate documentation and files as it relates to utilization management.
• Coordinates information and findings with the business office to help recognize or resolve possible payment problems.
• Attends daily treatment team to discuss patient needs and ensure that all disciplines are aware of patient insurance status and needs.
• Ensure that insurance benefits are verified in a timely manner.
• Communicates any UR or Quality issues as noted in the chart to supervisor immediately to ensure timely resolution of problems.
• Responds to telephone and Internet inquires.
• Researches insurance company guidelines and uses admission and continuing stay criteria for coverage.
• High School Diploma Required, Bachelor's Degree in social work, behavioral or mental health, or other related health field preferred.
• One or more years of direct clinical experience in a psychiatric or mental health setting preferred.
Why The Pavilion at Williamsburg Place?The Pavilion at Williamsburg Place offers a comprehensive benefit plan and a competitive salary commensurate with experience and qualifications. Qualified candidates should apply by submitting a resume. The Pavilion at Williamsburg Place is an EOE.
Veterans and military spouses are highly encouraged to apply. Summit BHC is dedicated to serving Veterans with specialized programming at our treatment centers across the country. We recognize and value the unique strengths of the military community in supporting our mission to serve those who have served.
About the Job:
The Utilization Assistant provides support to all utilization review/management activities of the hospital to continuously improve the collection, reimbursement, coordination, and presentation of utilization review information. Works with insurance providers to obtain coverage for patients. Assists in utilization reviews and insurance appeals. Responds to inquiries from patients, their families, and professional referral sources.
Roles and Responsibilities:
• Assists the admissions department with pre-certifications of care. Performs pre and post admission benefit verification with managed care organizations.
• Reviews medical records of patients for appropriateness of level of care at admission and at intervals determined by documentation in medical record.
• Conducts interactive and timely reviews with payers to ensure certification of care.
• Maintains accurate documentation and files as it relates to utilization management.
• Coordinates information and findings with the business office to help recognize or resolve possible payment problems.
• Attends daily treatment team to discuss patient needs and ensure that all disciplines are aware of patient insurance status and needs.
• Ensure that insurance benefits are verified in a timely manner.
• Communicates any UR or Quality issues as noted in the chart to supervisor immediately to ensure timely resolution of problems.
• Responds to telephone and Internet inquires.
• Researches insurance company guidelines and uses admission and continuing stay criteria for coverage.
• High School Diploma Required, Bachelor's Degree in social work, behavioral or mental health, or other related health field preferred.
• One or more years of direct clinical experience in a psychiatric or mental health setting preferred.
Why The Pavilion at Williamsburg Place?The Pavilion at Williamsburg Place offers a comprehensive benefit plan and a competitive salary commensurate with experience and qualifications. Qualified candidates should apply by submitting a resume. The Pavilion at Williamsburg Place is an EOE.
Veterans and military spouses are highly encouraged to apply. Summit BHC is dedicated to serving Veterans with specialized programming at our treatment centers across the country. We recognize and value the unique strengths of the military community in supporting our mission to serve those who have served.
About Summit BHC
Sourced by ZipRecruiter
Summit BHC, based in Franklin, TN, USA, is a recognized leader in the field of addiction treatment and behavioral health care services. The company operates a nationwide network of treatment centers aimed at caring for individuals battling substance abuse and mental health disorders. Summit BHC was established with the mission to provide high-quality, addiction treatment and behavioral health services to those in need throughout the United States. With compassion, dignity, and respect as their core values, they endeavor to instill hope during the journey to recovery and beyond.
Industry
Health care and social assistance
Company size
501 - 1,000 Employees
Headquarters location
Franklin, TN, US
Year founded
2013