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Utilization Review No Experience Jobs in Virginia

UHS

UTILIZATION REVIEW COORDINATOR

Danville, VA

Experience in patient assessment, family motivation, treatment planning and communication with ... Must have clear verbal speech with no impediments. 50% of time, incumbent is seated and talking ...

UHS

UTILIZATION REVIEW COORDINATOR

Danville, VA

Experience in patient assessment, family motivation, treatment planning and communication with ... Must have clear verbal speech with no impediments. 50% of time, incumbent is seated and talking ...

UHS

UTILIZATION REVIEW COORDINATOR

Danville, VA

Experience in patient assessment, family motivation, treatment planning and communication with ... Must have clear verbal speech with no impediments. 50% of time, incumbent is seated and talking ...

UHS

UTILIZATION REVIEW COORDINATOR

Danville, VA · On-site

Experience in patient assessment, family motivation, treatment planning and communication with ... Must have clear verbal speech with no impediments. 50% of time, incumbent is seated and talking ...

UHS

UTILIZATION REVIEW COORDINATOR

Danville, VA · On-site

$26 - $35/hr

Experience in patient assessment, family motivation, treatment planning and communication with ... Must have clear verbal speech with no impediments. 50% of time, incumbent is seated and talking ...

Summit BHC

Utilization Specialist

Williamsburg, VA · On-site

$60 - $80/hr

The Utilization Specialist is responsible for reviewing of assigned admissions, continued stays ... experience in a psychiatric or mental health setting required. · Current licensure as an LPN or ...

Summit BHC

Utilization Specialist

Williamsburg, VA · On-site

The Utilization Specialist is responsible for reviewing of assigned admissions, continued stays ... direct clinical experience in a psychiatric or mental health setting required. • Current ...

UHS

UTILIZATION COORDINATOR

Danville, VA · On-site

... review and respond to concerns expressed by customers. Together with the appropriate Department ... experience. During the recruitment process, no recruiter or employee will request financial or ...

Lancesoft INC

RN Case Manager

Chesapeake, VA · On-site

$2.3K - $2.4K/wk

... no exceptions) Certifications: BLS - Must be AHA-certified CCM or ACM preferred Required Skills: Discharge planning Utilization Review (UR) Experience in fast-paced surgical units EPIC charting ...

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All JobsUtilization Review JobsUtilization Review No Experience JobsUtilization Review No Experience Jobs in Virginia

Utilization Review No Experience information

What is utilization review?

Utilization review is a process used in healthcare to assess the necessity, appropriateness, and efficiency of the use of medical services, procedures, and facilities. Many entry-level utilization review positions are available for individuals with clinical backgrounds, such as nurses or social workers, even if they do not have prior experience in utilization review specifically. Employers often provide on-the-job training for candidates who understand medical terminology and have a background in healthcare. If you do not have a clinical license, you may need to seek administrative or support roles in utilization review to gain experience.

What are the key skills and qualifications needed to thrive as a utilization review specialist with no prior experience?

To thrive as a Utilization Review Specialist without prior experience, you generally need a healthcare-related degree, strong analytical skills, and a good understanding of medical terminology. Familiarity with case management software, electronic health records (EHR), and UR-specific platforms is typically required, and some roles may prefer candidates to pursue certification like Certified Utilization Review Specialist (CURA) over time. Attention to detail, effective communication, and strong organizational skills help new professionals excel in assessing medical necessity and collaborating with healthcare teams. These competencies ensure accurate reviews, regulatory compliance, and positive patient outcomes in a complex healthcare environment.

What are common challenges faced by entry-level professionals in utilization review and how can they be addressed?

Entry-level professionals in Utilization Review often face challenges such as learning complex medical terminology, understanding insurance regulations, and adapting to fast-paced review processes. To overcome these, it's helpful to seek mentorship from experienced team members, utilize available training resources, and stay organized with case management tools. Regular communication with clinical staff and supervisors also helps clarify protocols and expectations, making it easier to build confidence and competence in the role.

What is the difference between Utilization Review No Experience vs Utilization Review Coordinator?

AspectUtilization Review No ExperienceUtilization Review Coordinator
Required CredentialsHigh school diploma or equivalent; on-the-job trainingHigh school diploma; certification may be preferred
Work EnvironmentEntry-level, training-focused, healthcare settingsOffice-based, healthcare facilities, insurance companies
Employer & Industry UsageHospitals, insurance companies, healthcare providersInsurance companies, healthcare organizations, managed care
Search & Comparison IntentEntry-level, no experience, trainingCoordination, case management, healthcare review

Utilization Review No Experience roles are entry-level positions requiring minimal credentials and focus on training within healthcare settings. In contrast, Utilization Review Coordinators typically have some experience or certification, handling case management and review tasks in healthcare or insurance environments. Both roles are essential in healthcare utilization management but differ mainly in experience requirements and responsibilities.

Is utilization review a stressful job?

Utilization review can be stressful due to the need to evaluate medical cases accurately and efficiently while meeting strict deadlines. The role often involves high attention to detail, communication with healthcare providers, and managing workload, which can contribute to job-related stress. However, stress levels vary depending on the work environment and individual coping skills.

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 No Experience jobs in Virginia?

For Utilization Review No Experience jobs in Virginia, the most frequently searched job titles are:

What job categories do people searching Utilization Review No Experience jobs in Virginia look for?

The top searched job categories for Utilization Review No Experience jobs in Virginia are:

What cities in Virginia are hiring for Utilization Review No Experience jobs?

Cities in Virginia with the most Utilization Review No Experience job openings:

Utilization Review No Experience jobs near you
Infographic showing various Utilization Review No Experience job openings in Virginia as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution.

UTILIZATION REVIEW NURSE

Sentara Health Administration, Inc.

Norfolk, VA • On-site

$75 - $105/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 5 days ago

Job description

City/StateNorfolk, VAWork ShiftFirst (Days)Overview:Sentara Health Plans Community Care is looking to hire a Utilization Review Nurse.The Utilization Review Nurse is responsible for utilization management services within the scope of licensure. Conducts primary functions of prior authorization, retrospective review, medical director referrals and execution of member/provider approval and/or denial letter. Reviews provider requests for services requiring authorization. Conducts pre-certification, care coordination for appropriateness of treatment, set reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.Responsible for written and/or verbal notification to members and providers. Ensures medical director written decision is consistent with criteria (CMS, state, medical policy, clinical criteria). Facilitates accreditation by knowing, understanding, correctly interpreting, and accurately applying accrediting and regulatory requirements and standards.Education:· BSN (preferred)Certification:· Registered Nurse (required)Experience:· 3 years of acute care clinical experience (required)· Previous Utilization Review experience (preferred)· Milliman experience (preferred)· Knowledge of NCQA (preferred)· Microsoft suite (Word, Excel, Outlook) (preferred)· Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skillsKeywords: Talroo- Health, Utilization Review Nurse, RN, Care Coordination, or Discharge Planning, Case Management, Milliman, NCQABenefits: Caring For Your Family and Your Career• Medical, Dental, Vision plans• Adoption, Fertility and Surrogacy Reimbursement up to $10,000• Paid Time Off and Sick Leave• Paid Parental & Family Caregiver Leave• Emergency Backup Care• Long-Term, Short-Term Disability, and Critical Illness plans• Life Insurance• 401k/403B with Employer Match• Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education• Student Debt Pay Down – $10,000•Pet Insurance•Legal Resources Plan•Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.In support of our mission “to improve health every day,” this is a tobacco-free environment.For positions that are available as remote work, Sentara Health employs associates in the following states:Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. #J-18808-Ljbffr

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