Annandale, VA · On-site +1
$57 - $69.50/hr
Experience: Prior managed care or utilization management experience preferred - retail and hospital pharmacists with strong clinical and documentation skills are encouraged to apply. * Skills:
Annandale, VA · On-site +1
$57 - $69.50/hr
Experience: Prior managed care or utilization management experience preferred - retail and hospital pharmacists with strong clinical and documentation skills are encouraged to apply. * Skills:
Herndon, VA · On-site
Reporting to the Data Center Delivery Business Operations Manager, you will have the opportunity join a team that partners across the global AWS infrastructure organizations to shape the future of ...
Herndon, VA · On-site
Reporting to the Data Center Delivery Business Operations Manager, you will have the opportunity join a team that partners across the global AWS infrastructure organizations to shape the future of ...
Annandale, VA · Remote
$58 - $69.50/hr
Prior authorization, utilization management, or managed care preferred - retail or hospital pharmacists with strong clinical judgment are encouraged to apply. * Skills: Excellent clinical review ...
Annandale, VA · Remote
$58 - $69.50/hr
Prior authorization, utilization management, or managed care preferred - retail or hospital pharmacists with strong clinical judgment are encouraged to apply. * Skills: Excellent clinical review ...
As a Technical Infrastructure Program Manager within this team focused on global data center inventory and power topology accuracy, you will be responsible for organizing and managing continuous ...
As a Technical Infrastructure Program Manager within this team focused on global data center inventory and power topology accuracy, you will be responsible for organizing and managing continuous ...
As a Technical Infrastructure Program Manager within this team focused on global data center inventory and power topology accuracy, you will be responsible for organizing and managing continuous ...
As a Technical Infrastructure Program Manager within this team focused on global data center inventory and power topology accuracy, you will be responsible for organizing and managing continuous ...
Ashburn, VA · Remote
$59.50 - $71.50/hr
Prior authorization, utilization management, or managed care preferred - retail or hospital pharmacists with strong clinical judgment are encouraged to apply. * Skills: Excellent clinical review ...
Ashburn, VA · Remote
$59.50 - $71.50/hr
Prior authorization, utilization management, or managed care preferred - retail or hospital pharmacists with strong clinical judgment are encouraged to apply. * Skills: Excellent clinical review ...
Established utilization review and clinical revenue cycle program Part of integrated healthcare system with multiple hospital sites Collaborative environment with leadership, case management, and ...
Established utilization review and clinical revenue cycle program Part of integrated healthcare system with multiple hospital sites Collaborative environment with leadership, case management, and ...
... utilization management activities; and assists with risk management functions.
... utilization management activities; and assists with risk management functions.
As a Vascular Surgery, Field Medical Director 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 ...
As a Vascular Surgery, Field Medical Director 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 ...
Richmond, VA · On-site
$17 - $23/hr
Must have the ability to multitask and manage time effectively. Excellent written and verbal communication skills. * Outstanding problem-solving and organizational abilities.
Richmond, VA · On-site
$17 - $23/hr
Must have the ability to multitask and manage time effectively. Excellent written and verbal communication skills. * Outstanding problem-solving and organizational abilities.
$188K - $237K/yr
... utilization management activities; and assists with risk management functions.
$188K - $237K/yr
... utilization management activities; and assists with risk management functions.
Virginia Beach, VA · On-site +1
$83K - $103K/yr
The Manager may work remotely or in our Birmingham, AL headquarters. Essential Job Responsibilities ... Become a SME on dozens of medical vendor/PBM contracts including utilization rules, B/G ...
Virginia Beach, VA · On-site +1
$83K - $103K/yr
The Manager may work remotely or in our Birmingham, AL headquarters. Essential Job Responsibilities ... Become a SME on dozens of medical vendor/PBM contracts including utilization rules, B/G ...
... utilization management activities; and assists with risk management functions.
... utilization management activities; and assists with risk management functions.
... utilization management activities; and assists with risk management functions.
... utilization management activities; and assists with risk management functions.
$168K - $211K/yr
... utilization management activities; and assists with risk management functions.
$168K - $211K/yr
... utilization management activities; and assists with risk management functions.
$168K - $211K/yr
... utilization management activities; and assists with risk management functions.
$168K - $211K/yr
... utilization management activities; and assists with risk management functions.
Mclean, VA · On-site +1
Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Strong desktop skills including Word, Excel, PowerPoint * Work Experience/Direct Knowledge of ...
Mclean, VA · On-site +1
Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Strong desktop skills including Word, Excel, PowerPoint * Work Experience/Direct Knowledge of ...
Rosslyn, VA · On-site +1
Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Strong desktop skills including Word, Excel, PowerPoint * Work Experience/Direct Knowledge of ...
Rosslyn, VA · On-site +1
Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Strong desktop skills including Word, Excel, PowerPoint * Work Experience/Direct Knowledge of ...
Richmond, VA · On-site +1
Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Strong desktop skills including Word, Excel, PowerPoint * Work Experience/Direct Knowledge of ...
Richmond, VA · On-site +1
Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Strong desktop skills including Word, Excel, PowerPoint * Work Experience/Direct Knowledge of ...
Knowledge of formulary management, utilization management, and drug pricing strategies Strong financial acumen with experience in contract modeling and reimbursement analysis Knowledge of healthcare ...
Knowledge of formulary management, utilization management, and drug pricing strategies Strong financial acumen with experience in contract modeling and reimbursement analysis Knowledge of healthcare ...
$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
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.
| 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.
$57 - $69.50/hr
Other
Posted 17 days ago
Appeals Pharmacist - Ensure Fair Medication Access for Patients
A confidential managed care organization is seeking an experienced Appeals Pharmacist to review, evaluate, and process medication coverage appeals. This role is ideal for pharmacists who want to leverage their clinical knowledge and critical thinking skills to advocate for patients and ensure fair, evidence-based decisions.
Key Responsibilities
What You'll Bring
Why This Role?
About Us
We are a confidential healthcare partner working with health plans and managed care organizations nationwide. Our appeals pharmacists safeguard patient access while ensuring compliance with all regulatory standards.
Apply Today
Join our team as an Appeals Pharmacist and help ensure every patient receives a fair review of their medication needs.
