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Utilization Manager Jobs in Virginia (NOW HIRING)

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

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

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

Oncology - Radiation Physician

Arlington, VA · On-site

Field Medical Director, Radiation Oncology As a FMD, 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 ...

Evolent

Oncology - Radiation Physician

Arlington, VA

Field Medical Director, Radiation Oncology As a FMD, 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 ...

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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 Jul 21, 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 does a utilization manager do?

A utilization manager oversees the allocation and efficient use of resources, such as staff and equipment, to meet organizational goals. They analyze data, monitor utilization rates, and ensure compliance with policies, often using tools like spreadsheets or specialized software. This role requires strong organizational and communication skills to optimize productivity and control costs.

What jobs pay 4000 a week without a degree?

Utilization Managers typically require a relevant background in healthcare, logistics, or operations, and their salaries usually do not reach $4,000 weekly without specialized experience or certifications. High-paying roles that can reach this level without a degree often include sales, real estate, or skilled trades like certain construction or technical jobs, which rely more on experience and skills than formal education.

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 is the highest paying job in healthcare management?

The highest paying roles in healthcare management include Chief Executive Officers (CEOs) of hospitals and health systems, with salaries often exceeding $200,000 annually. Other high-paying positions include Chief Financial Officers (CFOs) and Chief Operating Officers (COOs), who oversee organizational strategy and operations, typically earning six-figure salaries. These roles require extensive experience, advanced degrees, and strong leadership skills.

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.

Is being a MOA a good entry level job?

A Medical Office Assistant (MOA) role is often considered an entry-level position in healthcare, requiring basic administrative skills and knowledge of medical terminology. It provides experience in patient interaction, scheduling, and office management, which can serve as a stepping stone to more advanced healthcare roles. However, career advancement may require additional certifications or education.
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 July 2026, with employment types broken down into 85% Full Time, 13% Part Time, 1% Temporary, and 1% Contract. Highlights an 86% Physical, 1% Hybrid, and 13% Remote job distribution, with an average salary of $90,231 per year, or $43.4 per hour.
Radiology Physician

Radiology Physician

Evolent

Arlington, VA

$368K - $460K/yr

Full-time

Posted 18 days ago

Evolent rating

8.4

Company rating: 8.4 out of 10

Based on 18 frontline employees who took The Breakroom Quiz

56th of 451 rated business services

Job description

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 better work- life balance on a team that values collaboration and continuous learning while providing better health outcomes.



Collaboration Opportunities:


  • Routinely interacts with leadership and management staff, other Physicians, and staff whenever a physician s input is needed or required.



What You Will Be Doing:


  • Serve as the Physician match reviewer in Imaging cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter expert.

  • Discusses determinations (peer to peer phone calls) with requesting physicians or ordering providers, when available, within the regulatory timeframe of the request and provides clinical rationale for standard and expedited appeals.

  • Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines.

  • Aids and acts as a resource to Initial Clinical Reviewers.

  • Ensures documentation of all communications with medical office staff and/or MD provider is recorded in a timely and accurate manner.

  • May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support.

  • Participates in on-going training per inter-rater reliability process.



Qualifications:


  • MD/DO/MBBS

  • Minimum of five (5) years experience in the practice of Medicine, post residency and Active Clinical practice within the last 2 years is preferred

  • Current, unrestricted clinical license in home state medicine or required specialty-

  • Obtaining and maintaining medical licenses in the state you reside, as well as, any license required per business needs

  • Active Board Certification by an accredited organization

  • Strong clinical, management, communication, and organizational skills

  • Energetic and curious with a passion for quality and value in health care

  • Computer Proficiency

  • Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as an excluded person by the Office of Inspector General of the Department of Health and Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by Medicare.

  • No history of a major disciplinary or legal action by a state medical board

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