The team leads utilization management (UM) efforts, clinical documentation improvement (CDI), education, and regulatory compliance. Our role is to drive performance improvements in length of stay ...
The team leads utilization management (UM) efforts, clinical documentation improvement (CDI), education, and regulatory compliance. Our role is to drive performance improvements in length of stay ...
UTILIZATION REVIEW NURSE THP
Washington, DC · On-site
Additional Information All your information will be kept confidential according to EEO guidelines.
UTILIZATION REVIEW NURSE THP
Washington, DC · On-site
Additional Information All your information will be kept confidential according to EEO guidelines.
RN UTILIZATION REVIEW
Washington, DC · On-site
Additional Information All your information will be kept confidential according to EEO guidelines.
RN UTILIZATION REVIEW
Washington, DC · On-site
Additional Information All your information will be kept confidential according to EEO guidelines.
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 ...
As a Cardiology, 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 Cardiology, 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 Cardiology, 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 Cardiology, 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 ...
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 ...
Registered Nurse (RN) Case Manager
Falls Church, VA · On-site
$85 - $110/hr
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 ...
Registered Nurse (RN) Case Manager
Falls Church, VA · On-site
$85 - $110/hr
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 ...
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 ...
Registered Nurse (RN) Case Manager
Alexandria, VA · On-site
$86K - $140K/yr
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 ...
Registered Nurse (RN) Case Manager
Alexandria, VA · On-site
$86K - $140K/yr
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 ...
Registered Nurse Case Manager - Observation Unit
Falls Church, VA · On-site
$85 - $110/hr
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 ...
Registered Nurse Case Manager - Observation Unit
Falls Church, VA · On-site
$85 - $110/hr
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 ...
Registered Nurse (RN) Case Manager
Falls Church, VA · On-site
$86K - $140K/yr
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 ...
Registered Nurse (RN) Case Manager
Falls Church, VA · On-site
$86K - $140K/yr
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 ...
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 ...
REMOTE - Vice President Medical Director of Clinical Programs
Washington, DC · Remote
$286K - $353K/yr
Provide clinical leadership across utilization management, care management, population health, quality, pharmacy, medical policy, payment policy, and clinical program development. * Lead cross ...
REMOTE - Vice President Medical Director of Clinical Programs
Washington, DC · Remote
$286K - $353K/yr
Provide clinical leadership across utilization management, care management, population health, quality, pharmacy, medical policy, payment policy, and clinical program development. * Lead cross ...
Senior Project Manager - Web Applications
Bethesda, MD · On-site
$160K - $180K/yr
Manage scope, schedule, cost, backlog, work authorization, and resource utilization across multiple customers * Lead release planning, risk/issue management, and stakeholder coordination * Coordinate ...
Senior Project Manager - Web Applications
Bethesda, MD · On-site
$160K - $180K/yr
Manage scope, schedule, cost, backlog, work authorization, and resource utilization across multiple customers * Lead release planning, risk/issue management, and stakeholder coordination * Coordinate ...
Senior Project Manager - Web Applications
Bethesda, MD · On-site
$160K - $180K/yr
Manage scope, schedule, cost, backlog, work authorization, and resource utilization across multiple customers * Lead release planning, risk/issue management, and stakeholder coordination * Coordinate ...
Senior Project Manager - Web Applications
Bethesda, MD · On-site
$160K - $180K/yr
Manage scope, schedule, cost, backlog, work authorization, and resource utilization across multiple customers * Lead release planning, risk/issue management, and stakeholder coordination * Coordinate ...
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 ...
Senior Project Manager - Web Applications
$160K - $180K/yr
Manage scope, schedule, cost, backlog, work authorization, and resource utilization across multiple customers * Lead release planning, risk/issue management, and stakeholder coordination * Coordinate ...
Senior Project Manager - Web Applications
$160K - $180K/yr
Manage scope, schedule, cost, backlog, work authorization, and resource utilization across multiple customers * Lead release planning, risk/issue management, and stakeholder coordination * Coordinate ...
Utilization Manager information
See Washington salary details
$44.2K - $57.4K
9% of jobs
$67.2K is the 25th percentile. Wages below this are outliers.
$57.4K - $70.6K
22% of jobs
$70.6K - $83.9K
11% of jobs
The median wage is $92K / yr.
$83.9K - $97.1K
14% of jobs
$97.1K - $110.3K
12% of jobs
$118.6K is the 75th percentile. Wages above this are outliers.
$110.3K - $123.6K
13% of jobs
$123.6K - $136.8K
13% of jobs
$136.8K - $150K
5% of jobs
$150K - $163.2K
2% of jobs
$163.2K - $176.5K
0% of jobs
$176.5K - $189.7K
0% of jobs
$44.2K
$103.1K
$189.7K
How much do utilization manager jobs pay per year?
As of Sep 5, 2026, the average yearly pay for utilization manager in Washington is $103,079.00, according to ZipRecruiter salary data. Most workers in this role earn between $67,400.00 and $124,000.00 per year, depending on experience, location, and employer.
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 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 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 Washington?
The most popular types of Utilization jobs in Washington are:
What are popular job titles related to Utilization Manager jobs in Washington?
For Utilization Manager jobs in Washington, the most frequently searched job titles are:
What job categories do people searching Utilization Manager jobs in Washington look for?
The top searched job categories for Utilization Manager jobs in Washington are:
What cities in Washington are hiring for Utilization Manager jobs?
Cities in Washington with the most Utilization Manager job openings:
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For Utilization Manager jobs in WA, the most frequently searched job titles are:
Other
Medical, Retirement, PTO
Re-posted 21 days ago
Job description
Join our Medical Group as an Executive Leader as a Medical Director, Advisory Services - A Role Designed for You
An experienced physician leader to provide on-site advisory services and lead utilization management (UM), compliance, and clinical documentation improvement (CDI) efforts to our partner hospitals. In this unique role, you will provide advisory services and the opportunity to work with hospital administration to identify and address performance improvement opportunities, potentially including length of stay, readmissions, improved documentation, and regulatory compliance.
Team Collaboration:
- Together, collaborate to provide expert guidance and drive better outcomes.
- Our physician advisors operate across multiple states, including Arizona, California, Florida, Kentucky, Nevada, and West Virginia, collaborating with partner hospitals to improve services and outcomes.
- The team leads utilization management (UM) efforts, clinical documentation improvement (CDI), education, and regulatory compliance. Our role is to drive performance improvements in length of stay, readmissions, and documentation.
Qualifications:
- MD or DO licensure within the state of employment.
- Experience in Utilization Management, compliance, and clinical documentation preferred.
- Strong leadership, education, and collaboration skills.
- Board Certification (base specialty) recognized by ABMS or ABQAURP.
- Education on the application of medical necessity criteria within three months of hire.
- Three years of post-residency experience as a physician advisor preferred.
- Authorized to work in the United States.
Scheduling:
- Monday - Friday, providing a healthy work-life balance.
Key Responsibilities:
- Provide leadership and oversight of advisory services.
- Serve as a visible physician leader and advocate for improved regulatory compliance, improved documentation, and improved utilization of hospital resources.
- Provide support to address and reduce payer denials.
- Develop action plans on performance improvement opportunities.
- Provide one-on-one as well as group education to the medical staff.
- Provide timely and effective consultation to case management, CDI specialists, physicians, and other staff at the hospital with documented determinations and observations.
Rewards and Compensation:
- Competitive base salary, commensurate with experience.
- Health benefits, CME allowance, PTO, and 401k.
Cindy Mitchum, Clinical Recruiter | cmitchum@soundphysicians.com | (706) 799-3592
About Sound Physicians
Sourced by ZipRecruiter
Sound Physicians is a leading physician partner to hospitals, health plans, physician groups, and post-acute providers seeking to transform outcomes for acute episodes of care. For 20 years our high-performing and affordable care models have combined physician leadership, clinical process, technology and analytics to consistently improve clinical and financial performance. We are pioneers in value, working together with our partners and community providers to bridge gaps in care, from hospital to home.
Industry
Health care and social assistance
Company size
1,001 - 5,000 Employees
Headquarters location
Tacoma, WA, US
Year founded
2001