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 ...
Quick apply
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 ...
RN Utilization Manager Optum Home & Community Care, part of the Optum family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated ...
New
RN Utilization Manager Optum Home & Community Care, part of the Optum family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated ...
New
Largo, MD · On-site
$406K/yr
Under general supervision, provides utilization review and denials management for an assigned patient case load. This role utilizes nationally recognized care guidelines/criteria to assess the ...
Largo, MD · On-site
$406K/yr
Under general supervision, provides utilization review and denials management for an assigned patient case load. This role utilizes nationally recognized care guidelines/criteria to assess the ...
Largo, MD · On-site
$40.61 - $60.96/hr
Under general supervision, provides utilization review and denials management for an assigned patient case load. This role utilizes nationally recognized care guidelines/criteria to assess the ...
Largo, MD · On-site
$40.61 - $60.96/hr
Under general supervision, provides utilization review and denials management for an assigned patient case load. This role utilizes nationally recognized care guidelines/criteria to assess the ...
Glen Burnie, MD · On-site
$386K/yr
... with case manager, physician advisor, medical team and payors as needed regarding reviews and ... Knowledge, Skills and Abilities 1. Knowledge of utilization management is preferred. 2. Highly ...
Glen Burnie, MD · On-site
$386K/yr
... with case manager, physician advisor, medical team and payors as needed regarding reviews and ... Knowledge, Skills and Abilities 1. Knowledge of utilization management is preferred. 2. Highly ...
... with case manager, physician advisor, medical team and payors as needed regarding reviews and ... Knowledge, Skills and Abilities 1. Knowledge of utilization management is preferred. 2. Highly ...
... with case manager, physician advisor, medical team and payors as needed regarding reviews and ... Knowledge, Skills and Abilities 1. Knowledge of utilization management is preferred. 2. Highly ...
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
Role Overview Under the direction of a supervisor, the Utilization Management Reviewer evaluates medical necessity for inpatient and outpatient services, ensuring treatment aligns with clinical ...
Role Overview Under the direction of a supervisor, the Utilization Management Reviewer evaluates medical necessity for inpatient and outpatient services, ensuring treatment aligns with clinical ...
Spectrum Healthcare Resources has an opportunity for a Registered Nurse Utilization Management (UMRN) working at Joint Base Andrews in Washington, D.C. Requirements: * Associates Degree of Nursing
Spectrum Healthcare Resources has an opportunity for a Registered Nurse Utilization Management (UMRN) working at Joint Base Andrews in Washington, D.C. Requirements: * Associates Degree of Nursing
Spectrum Healthcare Resources has an opportunity for a Registered Nurse Utilization Management (UMRN) working at Joint Base Andrews in Washington, D.C. Requirements: * Associates Degree of Nursing
Spectrum Healthcare Resources has an opportunity for a Registered Nurse Utilization Management (UMRN) working at Joint Base Andrews in Washington, D.C. Requirements: * Associates Degree of Nursing
Spectrum Healthcare Resources has an opportunity for a Registered Nurse Utilization Management (UMRN) working at Joint Base Andrews in Washington, D.C. Requirements: * Associates Degree of Nursing
Spectrum Healthcare Resources has an opportunity for a Registered Nurse Utilization Management (UMRN) working at Joint Base Andrews in Washington, D.C. Requirements: * Associates Degree of Nursing
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 ...
Monitors and identifies patterns or trends in utilization management; monitors potential and actual denials and collaborates with care coordinator for any follow up necessary; documents actions taken ...
Monitors and identifies patterns or trends in utilization management; monitors potential and actual denials and collaborates with care coordinator for any follow up necessary; documents actions taken ...
Monitors and identifies patterns or trends in utilization management; monitors potential and actual denials and collaborates with care coordinator for any follow up necessary; documents actions taken ...
Monitors and identifies patterns or trends in utilization management; monitors potential and actual denials and collaborates with care coordinator for any follow up necessary; documents actions taken ...
Washington, DC · On-site
$27.02 - $36.78/hr
The Utilization Management Technician functions under the direction of the Supervisor to coordinate, generate and track both incoming and outgoing correspondence, faxes and authorizations related to ...
Washington, DC · On-site
$27.02 - $36.78/hr
The Utilization Management Technician functions under the direction of the Supervisor to coordinate, generate and track both incoming and outgoing correspondence, faxes and authorizations related to ...
Washington, DC · On-site +1
$27.02 - $36.78/hr
The Utilization Management Technician functions under the direction of the Supervisor to coordinate, generate and track both incoming and outgoing correspondence, faxes and authorizations related to ...
Washington, DC · On-site +1
$27.02 - $36.78/hr
The Utilization Management Technician functions under the direction of the Supervisor to coordinate, generate and track both incoming and outgoing correspondence, faxes and authorizations related to ...
Washington, DC · On-site +1
$27.02 - $36.78/hr
The Utilization Management Technician functions under the direction of the Supervisor to coordinate, generate and track both incoming and outgoing correspondence, faxes and authorizations related to ...
Washington, DC · On-site +1
$27.02 - $36.78/hr
The Utilization Management Technician functions under the direction of the Supervisor to coordinate, generate and track both incoming and outgoing correspondence, faxes and authorizations related to ...
Role Overview Under the direction of the Supervisor, the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and ...
Role Overview Under the direction of the Supervisor, the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and ...
Role Overview Under the direction of the Supervisor, the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and ...
Role Overview Under the direction of the Supervisor, the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and ...
$40.8K - $53.1K
9% of jobs
$62.1K is the 25th percentile. Wages below this are outliers.
$53.1K - $65.3K
22% of jobs
$65.3K - $77.5K
11% of jobs
The median wage is $85K / yr.
$77.5K - $89.7K
14% of jobs
$89.7K - $102K
12% of jobs
$109.6K is the 75th percentile. Wages above this are outliers.
$102K - $114.2K
13% of jobs
$114.2K - $126.4K
13% of jobs
$126.4K - $138.7K
5% of jobs
$138.7K - $150.9K
2% of jobs
$150.9K - $163.1K
0% of jobs
$163.1K - $175.3K
0% of jobs
$40.8K
$95.3K
$175.3K
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.
For Utilization Manager jobs in Washington, DC, the most frequently searched job titles are:
The top searched job categories for Utilization Manager jobs in Washington, DC are:

Full-time
Medical, PTO
Re-posted 26 days ago
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:
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.
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Recruiting and staffing services
201 - 500 Employees
New York, NY, US