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 ...
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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 ...
The SME will apply utilization-management expertise to assess clinical processes, medical-necessity workflows, referral and authorization processes, care coordination, utilization patterns, and ...
New
The SME will apply utilization-management expertise to assess clinical processes, medical-necessity workflows, referral and authorization processes, care coordination, utilization patterns, and ...
New
The RN Utilization Manager is accountable for HCBS Review Case Managers who perform evaluation of Home and Community Based Services (HCBS) of members in the Optum at Home Long Term Services and ...
The RN Utilization Manager is accountable for HCBS Review Case Managers who perform evaluation of Home and Community Based Services (HCBS) of members in the Optum at Home Long Term Services and ...
The RN Utilization Manager is accountable for HCBS Review Case Managers who perform evaluation of Home and Community Based Services (HCBS) of members in the Optum at Home Long Term Services and ...
The RN Utilization Manager is accountable for HCBS Review Case Managers who perform evaluation of Home and Community Based Services (HCBS) of members in the Optum at Home Long Term Services and ...
Director Utilization Management MedStar Family Choice
Washington, DC · On-site
$120K - $238K/yr
About the Job General Summary of Position The Director of Utilization Management (UM) provides strategic and operational leadership for the health plan's centralized utilization management function ...
Director Utilization Management MedStar Family Choice
Washington, DC · On-site
$120K - $238K/yr
About the Job General Summary of Position The Director of Utilization Management (UM) provides strategic and operational leadership for the health plan's centralized utilization management function ...
Informs department director of changes in managed care companies. Maintains awareness of unique ... Six months psychiatric utilization review either for hospital or external review organization ...
Informs department director of changes in managed care companies. Maintains awareness of unique ... Six months psychiatric utilization review either for hospital or external review organization ...
Informs department director of changes in managed care companies. Maintains awareness of unique ... Six months psychiatric utilization review either for hospital or external review organization ...
Informs department director of changes in managed care companies. Maintains awareness of unique ... Six months psychiatric utilization review either for hospital or external review organization ...
Utilization Review Coordinator
Washington, DC · On-site
$33.60 - $50.40/hr
Informs department director of changes in managed care companies. Maintains awareness of unique ... Six months psychiatric utilization review either for hospital or external review organization ...
Utilization Review Coordinator
Washington, DC · On-site
$33.60 - $50.40/hr
Informs department director of changes in managed care companies. Maintains awareness of unique ... Six months psychiatric utilization review either for hospital or external review organization ...
Registered Nurse Case Manager
$40 - $50/hr
The Registered Nurse Case Manager provides comprehensive case management and referral/utilization management services, coordinating patient care across the continuum to promote quality, cost ...
New
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Registered Nurse Case Manager
$40 - $50/hr
The Registered Nurse Case Manager provides comprehensive case management and referral/utilization management services, coordinating patient care across the continuum to promote quality, cost ...
New
Registered Nurse Case Manager
Bethesda, MD · On-site
$40 - $50/hr
The Registered Nurse Case Manager provides comprehensive case management and referral/utilization management services, coordinating patient care across the continuum to promote quality, cost ...
New
Registered Nurse Case Manager
Bethesda, MD · On-site
$40 - $50/hr
The Registered Nurse Case Manager provides comprehensive case management and referral/utilization management services, coordinating patient care across the continuum to promote quality, cost ...
New
Registered Nurse - Case Manager
$40 - $50/hr
The Registered Nurse - Case Manager provides comprehensive case management and referral/utilization management services, coordinating patient care across the continuum to promote quality, cost ...
New
Quick apply
Registered Nurse - Case Manager
$40 - $50/hr
The Registered Nurse - Case Manager provides comprehensive case management and referral/utilization management services, coordinating patient care across the continuum to promote quality, cost ...
New
Registered Nurse Case Manager
Bethesda, MD · On-site
$40 - $50/hr
The Registered Nurse Case Manager provides comprehensive case management and referral/utilization management services, coordinating patient care across the continuum to promote quality, cost ...
New
Registered Nurse Case Manager
Bethesda, MD · On-site
$40 - $50/hr
The Registered Nurse Case Manager provides comprehensive case management and referral/utilization management services, coordinating patient care across the continuum to promote quality, cost ...
New
Additional Information All your information will be kept confidential according to EEO guidelines.
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 ...
Utilization Manager information
See Ashburn, VA salary details
$39.9K - $51.8K
9% of jobs
$60.6K is the 25th percentile. Wages below this are outliers.
$51.8K - $63.8K
22% of jobs
$63.8K - $75.7K
11% of jobs
The median wage is $83.1K / yr.
$75.7K - $87.7K
14% of jobs
$87.7K - $99.6K
12% of jobs
$107.1K is the 75th percentile. Wages above this are outliers.
$99.6K - $111.6K
13% of jobs
$111.6K - $123.5K
13% of jobs
$123.5K - $135.4K
5% of jobs
$135.4K - $147.4K
2% of jobs
$147.4K - $159.3K
0% of jobs
$159.3K - $171.3K
0% of jobs
$39.9K
$93.1K
$171.3K
How much do utilization manager jobs pay per year?
As of Sep 6, 2026, the average yearly pay for utilization manager in Ashburn, VA is $93,069.00, according to ZipRecruiter salary data. Most workers in this role earn between $60,800.00 and $112,000.00 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 Ashburn, VA?
The most popular types of Utilization jobs in Ashburn, VA are:
What are popular job titles related to Utilization Manager jobs in Ashburn, VA?
For Utilization Manager jobs in Ashburn, VA, the most frequently searched job titles are:
What job categories do people searching Utilization Manager jobs in Ashburn, VA look for?
The top searched job categories for Utilization Manager jobs in Ashburn, VA are:
What cities near Ashburn, VA are hiring for Utilization Manager jobs?
Cities near Ashburn, VA with the most Utilization Manager job openings:
Full-time
Medical, PTO
Re-posted 27 days 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.
About Saratoga Medical Center
Sourced by ZipRecruiter
Industry
Recruiting and staffing services
Company size
201 - 500 Employees
Headquarters location
New York, NY, US