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Utilization Review Manager Jobs in Virginia (NOW HIRING)

American Traveler

Travel Case Manager

Chesapeake, VA · On-site

Acute Care Case Management * Discipline: RN * Start Date: 09/14/2026 * Duration: 13 weeks * 40 ... Utilization Review experience required * Recent experience with discharge planning in an adult ...

Carilion Clinic

RN Case Manager

Roanoke, VA

Collaborates with Utilization Review Nurse. * Maintains regular contact with assigned Utilization ... Manages changes to the plan as necessary. * Maintains effective communications with all disciplines ...

Carilion Clinic

RN Case Manager

Roanoke, VA

Collaborates with Utilization Review Nurse. * Maintains regular contact with assigned Utilization ... Manages changes to the plan as necessary. * Maintains effective communications with all disciplines ...

Carillion Clinic

RN Case Manager

Roanoke, VA · On-site

Collaborates with Utilization Review Nurse. * Maintains regular contact with assigned Utilization ... Manages changes to the plan as necessary. * Maintains effective communications with all disciplines ...

Carilion Clinic

RN Case Manager

Roanoke, VA

Collaborates with Utilization Review Nurse. * Maintains regular contact with assigned Utilization ... Manages changes to the plan as necessary. * Maintains effective communications with all disciplines ...

Carilion Clinic

RN Case Manager

Roanoke, VA · On-site

Collaborates with Utilization Review Nurse. * Maintains regular contact with assigned Utilization ... Manages changes to the plan as necessary. * Maintains effective communications with all disciplines ...

Carilion Clinic

RN Case Manager

Roanoke, VA

Collaborates with Utilization Review Nurse. * Maintains regular contact with assigned Utilization ... Manages changes to the plan as necessary. * Maintains effective communications with all disciplines ...

Carillion Clinic

RN Case Manager - Weekends

Roanoke, VA · On-site

Collaborates with Utilization Review Nurse. * Maintains regular contact with assigned Utilization ... Manages changes to the plan as necessary. * Maintains effective communications with all disciplines ...

Carillion Clinic

RN Case Manager - Weekdays

Roanoke, VA · On-site

Collaborates with Utilization Review Nurse. * Maintains regular contact with assigned Utilization ... Manages changes to the plan as necessary. * Maintains effective communications with all disciplines ...

Carilion Clinic

RN Case Manager - Weekdays

Roanoke, VA · On-site

Collaborates with Utilization Review Nurse. * Maintains regular contact with assigned Utilization ... Manages changes to the plan as necessary. * Maintains effective communications with all disciplines ...

Carilion Clinic

RN Case Manager - Weekends

Roanoke, VA · On-site

Collaborates with Utilization Review Nurse. * Maintains regular contact with assigned Utilization ... Manages changes to the plan as necessary. * Maintains effective communications with all disciplines ...

Carilion Clinic

RN Case Manager - Weekends

Roanoke, VA · On-site

Collaborates with Utilization Review Nurse. * Maintains regular contact with assigned Utilization ... Manages changes to the plan as necessary. * Maintains effective communications with all disciplines ...

Carilion Clinic

RN Case Manager - Weekdays

Roanoke, VA · On-site

Collaborates with Utilization Review Nurse. * Maintains regular contact with assigned Utilization ... Manages changes to the plan as necessary. * Maintains effective communications with all disciplines ...

Carilion Clinic

RN Case Manager - Weekends

Roanoke, VA · On-site

Collaborates with Utilization Review Nurse. * Maintains regular contact with assigned Utilization ... Manages changes to the plan as necessary. * Maintains effective communications with all disciplines ...

Dane Street

Board-Certified Pulmonology

Chesterfield, VA · On-site

$305K - $406K/yr

Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams

Dane Street, LLC

Board-Certified Pulmonology

Chesterfield, VA · On-site

$285K - $380K/yr

Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams

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Showing results 41-60

All JobsUtilization Review JobsUtilization Review Manager JobsUtilization Review Manager Jobs in Virginia

Utilization Review Manager information

See Virginia salary details

$38.7K

$90.2K

$166.1K

How much do utilization review manager jobs pay per year?

As of Aug 23, 2026, the average yearly pay for utilization review 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 review manager do?

A Utilization Review Manager oversees the process of evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. They ensure that patient care adheres to established guidelines and that healthcare resources are used effectively. Their duties typically include leading a team of reviewers, collaborating with healthcare providers, ensuring compliance with regulations, and making recommendations on care authorization. The goal is to balance quality patient care with cost-effective resource management.

What are the key skills and qualifications needed to thrive as a utilization review manager?

To thrive as a Utilization Review Manager, you need a solid background in healthcare management, clinical knowledge (often as an RN or healthcare professional), and experience with utilization review processes. Familiarity with case management software, electronic health records (EHRs), and certifications such as Certified Case Manager (CCM) or Certified Professional in Utilization Review (CPUR) are often expected. Strong analytical thinking, attention to detail, leadership, and effective communication are crucial soft skills for success in this role. These skills ensure appropriate resource use, regulatory compliance, and coordinated patient care, which are vital for both healthcare quality and operational efficiency.

What are some common challenges faced by utilization review managers in balancing patient care and cost efficiency?

Utilization Review Managers often encounter the challenge of ensuring patients receive appropriate care while also adhering to insurance and regulatory guidelines that emphasize cost efficiency. This requires strong analytical skills to assess clinical information and make fair determinations, often under tight deadlines and with incomplete data. The role also involves frequent communication with physicians, payers, and case managers to resolve disagreements and clarify criteria, making negotiation and diplomacy essential. Staying updated on changing healthcare regulations and payer requirements can add to the complexity, but it also provides opportunities for professional growth and leadership within healthcare administration.

What is the difference between Utilization Review Manager vs Utilization Review Coordinator?

AspectUtilization Review ManagerUtilization Review Coordinator
CertificationsTypically requires certifications like CCM or ACUMay require similar certifications but often less advanced
Work EnvironmentSupervises review teams, manages processes in healthcare or insurance settingsPerforms case reviews, supports the review process under supervision
Employer & IndustryHospitals, insurance companies, healthcare organizationsInsurance companies, healthcare providers, third-party administrators

The Utilization Review Manager oversees review teams and manages utilization review processes, focusing on policy compliance and efficiency. The Utilization Review Coordinator supports the review process by conducting case assessments and assisting managers. While both roles require similar certifications and work in related environments, the manager holds a supervisory position with broader responsibilities.

How much does a utilization review manager make?

A utilization review manager typically earns between $70,000 and $110,000 annually, depending on experience, location, and the size of the organization. They often require knowledge of healthcare policies, insurance processes, and may hold certifications such as URAC or CCM.

Is utilization review manager a stressful job?

Utilization review managers often work in a fast-paced healthcare environment, which can be stressful due to the need to meet strict deadlines, ensure accurate assessments, and handle complex cases. The role requires strong organizational skills and attention to detail, and some individuals may find the responsibility and workload challenging, especially during high-volume periods.

What are the most commonly searched types of Utilization Review jobs in Virginia?

The most popular types of Utilization Review jobs in Virginia are:

What are popular job titles related to Utilization Review Manager jobs in Virginia?

For Utilization Review Manager jobs in Virginia, the most frequently searched job titles are:

What job categories do people searching Utilization Review Manager jobs in Virginia look for?

The top searched job categories for Utilization Review Manager jobs in Virginia are:

What cities in Virginia are hiring for Utilization Review Manager jobs?

Cities in Virginia with the most Utilization Review Manager job openings:

Utilization Review Manager jobs near you
Infographic showing various Utilization Review Manager job openings in Virginia as of August 2026, with employment types broken down into 80% Full Time, 19% Part Time, and 1% Contract. Highlights an 81% Physical, 2% Hybrid, and 17% Remote job distribution, with an average salary of $90,231 per year, or $43.4 per hour.

Travel Case Manager

American Traveler

Chesapeake, VA • On-site

Contractor

Medical, Dental, Vision, Life, Retirement

Posted 26 days ago

Job description

American Traveler is seeking a travel nurse RN Case Manager, Acute Care Case Management for a travel nursing job in Chesapeake, Virginia.

Job Description & Requirements
  • Specialty: Acute Care Case Management
  • Discipline: RN
  • Start Date: 09/14/2026
  • Duration: 13 weeks
  • 40 hours per week
  • Shift: 8 hours, days
  • Employment Type: Travel
Assignment Overview
  • Shift: Days, 5x8hrs
  • Hours: 40 hrs/wk
  • Start Date: Sep 14, 2026
  • Length: 13 weeks
  • Openings: 1
Description

American Traveler is hiring an experienced RN Case Manager for an acute care hospital setting, requiring an active VA or Compact RN license and a minimum of 5 years of recent acute care Case Management experience.

Details
  • Work in the Case Management department of an acute care hospital setting
  • Adult acute care patient population with discharge planning needs
  • Previous patient census of approximately 15-25 patients with a 1:22 patient ratio
  • Uses Epic charting system
  • 5x8 day shift schedule, 8:00 AM to 4:30 PM, weekdays with some weekends
  • Some holiday coverage required
  • No overtime without supervisor approval
Requirements
  • Active Virginia or Compact RN license required in hand at time of consideration
  • BLS certification through the American Heart Association required
  • CCM (Certified Case Manager) and ACM (Accredited Case Manager) certifications preferred
  • Minimum 5 years of recent acute care Case Management experience in a hospital setting required
  • At least 3 years of recent experience as a unit-based inpatient case manager required
  • Less than a 6-month gap since last acute care Case Management role
  • Experience in a Level I, II, or III trauma acute care hospital required
  • Utilization Review experience required
  • Recent experience with discharge planning in an adult acute care hospital setting required
  • Proficiency in Epic required
  • Rated 4/5 or 5/5 across all Case Management functions, including knowledge of CMS regulations
  • Teaching hospital and community hospital experience preferred
  • Trauma Level I and II experience preferred
  • Ability to effectively manage a high-volume, fast-paced patient population
  • Previous travel experience strongly preferred; first-time travelers considered only with extensive acute care Case Management experience
  • PAPR fit testing cannot be accommodated
Additional Information
  • Coordinate care, conduct utilization review, and manage discharge planning for an adult acute care patient population
  • Responsibilities include admission criteria review, appeals and denials, audits, concurrent review, continued stay reviews, and determining medical necessity per evidence-based guidelines
  • Utilize Milliman guidelines and CMS regulations in daily case management functions
  • Assess patient needs and coordinate DME orders and plans of care
  • Must reside more than 50 miles from the facility to be considered for this position
  • Longer assignment length through January 9, 2027 may be available but is not required
  • Travelers must work two of the three winter holidays
  • Candidates with any license or background history hits will not be considered
  • First-time travelers will only be considered if they have extensive acute care Case Management experience

American Traveler Job ID #P-736462. Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Travel RN - Case Management/Utilization Review - Case Management

About American Traveler

With over 25 years of experience, American Traveler has established a reputation for outstanding customer service. Our team ensures a smooth, worry-free experience for those starting on or expanding their travel nursing and allied careers.

With thousands of travel nursing and allied jobs nationwide, our attentive and approachable recruiters find positions that align perfectly with your career aspirations and personal requirements.

American Traveler offers exceptional benefits, including premium medical, dental, vision and life insurance beginning day one of your assignment, generous 401(k) match, substantial housing stipends, and more. Additionally, with 24/7 support and access to our in-house clinicians, you are assured confidence and comfort throughout your assignment.

With our team behind you, you can relax and enjoy a rewarding travel career.

American Traveler logo

About American Traveler

Sourced by ZipRecruiter

With over 20 years of success in healthcare staffing, American Traveler has established a reputation for outstanding customer service. Our full-service agency has earned top ratings from healthcare professionals in every specialty and setting. We offer travel assignments in the most sought-after locations and facilities in the country. We staff major medical centers, prestigious university teaching facilities, Magnet facilities, regional community hospitals, outpatient centers, rehab centers, skilled nursing facilities and more. With our expert team behind you every step of the way, you can enjoy a rewarding travel career that exceeds your expectations. With over 20 years of experience, American Traveler has established a reputation for outstanding customer service. With our team behind you, you can relax and enjoy a rewarding travel career.

Industry

Recruiting and staffing services

Company size

501 - 1,000 Employees

Headquarters location

Boca Raton, FL, US

Year founded

1999

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