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Utilization Review Rn Jobs in Virginia (NOW HIRING)

Lifepoint Health

RN Director Case Management

Danville, VA · On-site

$101K - $136K/yr

Our collaborative approach to safe, effective discharge planning includes close coordination between a Utilization Review RN, Case Manager RN, and Social Worker-ensuring each patient receives ...

Carillion Clinic

RN Case Manager

Roanoke, VA · On-site

RN Case Manager (Open) Full time : Monday - Friday, 8am-4:30pm Sign on bonus and relocation ... Collaborates with Utilization Review Nurse. * Maintains regular contact with assigned Utilization ...

Carilion Clinic

RN Case Manager

Roanoke, VA · On-site

R151592 RN Case Manager (Open) How You'll Help Transform Healthcare: Full time : Monday - Friday ... Collaborates with Utilization Review Nurse. * Maintains regular contact with assigned Utilization ...

Carilion Clinic

RN Case Manager

Roanoke, VA · On-site

R151592 RN Case Manager (Open) How You'll Help Transform Healthcare: Full time : Monday - Friday ... Collaborates with Utilization Review Nurse. * Maintains regular contact with assigned Utilization ...

American Traveler

Travel Case Manager

Chesapeake, VA · On-site

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 ...

Carilion Clinic

RN Case Manager - Weekends

Roanoke, VA · On-site

R152941 RN Case Manager - Weekends (Open) How You'll Help Transform Healthcare: The RN Case Manager ... Collaborates with Utilization Review Nurse. * Maintains regular contact with assigned Utilization ...

Carilion Clinic

RN Case Manager - Weekends

Roanoke, VA · On-site

R161382 RN Case Manager - Weekends (Open) How You'll Help Transform Healthcare: Full time and ... Collaborates with Utilization Review Nurse. * Maintains regular contact with assigned Utilization ...

Carilion Clinic

RN Case Manager - Weekdays

Roanoke, VA · On-site

R161366 RN Case Manager - Weekdays (Open) How You'll Help Transform Healthcare: Monday - Friday ... Collaborates with Utilization Review Nurse. * Maintains regular contact with assigned Utilization ...

Carilion Clinic

RN Case Manager - Weekends

Roanoke, VA · On-site

R152941 RN Case Manager - Weekends (Open) How You'll Help Transform Healthcare: The RN Case Manager ... Collaborates with Utilization Review Nurse. * Maintains regular contact with assigned Utilization ...

Carilion Clinic

RN Case Manager - Weekends

Roanoke, VA · On-site

R161382 RN Case Manager - Weekends (Open) How You'll Help Transform Healthcare: Full time and ... Collaborates with Utilization Review Nurse. * Maintains regular contact with assigned Utilization ...

UnitiMed

RN Case Manager

Charlottesville, VA · On-site

Referral bonus up to $700 Registered Nurse (RN),Case Management/Utilization Review, About the Company: Uniti Med is an award-winning healthcare staffing company with a mission to provide staffing ...

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All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Virginia

Utilization Review Rn information

See Virginia salary details

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$41

$68

How much do utilization review rn jobs pay per hour?

As of Aug 13, 2026, the average hourly pay for utilization review rn in Virginia is $41.92, according to ZipRecruiter salary data. Most workers in this role earn between $33.12 and $48.12 per hour, depending on experience, location, and employer.

How does a utilization review RN collaborate with physicians and other healthcare professionals during the patient care review process?

A Utilization Review RN works closely with physicians, case managers, and other healthcare team members to ensure that patients receive appropriate care while adhering to regulatory and insurance guidelines. This collaboration often involves discussing clinical findings, clarifying documentation, and negotiating care plans to meet both patient needs and payer requirements. Effective communication and teamwork are essential, as Utilization Review RNs frequently serve as liaisons between clinical staff and insurance representatives to facilitate timely authorizations and prevent unnecessary delays in patient care.

What are the key skills and qualifications needed to thrive as a utilization review RN, and why are they important?

To thrive as a Utilization Review RN, you need a current RN license, strong clinical assessment skills, and knowledge of healthcare regulations and insurance guidelines. Familiarity with utilization management software, electronic health records (EHRs), and relevant certifications like CCM or ACM is often required. Excellent critical thinking, communication, and negotiation skills help you advocate for appropriate patient care while collaborating with providers and payers. These skills ensure cost-effective, quality care and compliance with regulatory standards in healthcare delivery.

How to get into utilization review as a registered nurse?

To become a utilization review RN, you typically need a valid registered nurse license and experience in clinical settings. Additional certifications such as the Certified Professional in Healthcare Quality (CPHQ) or knowledge of medical coding and insurance processes can enhance your qualifications. Gaining experience in case management or health insurance companies can also improve your chances of entering the field.

What is the difference between Utilization Review Rn vs Case Manager?

AspectUtilization Review RnCase Manager
CredentialsRN license, certifications in utilization reviewRN license, certifications in case management
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, community agencies, insurance companies
Primary FocusReviewing medical necessity and appropriateness of careCoordinating patient care and discharge planning

Utilization Review Rns primarily focus on evaluating the necessity of medical treatments, while Case Managers coordinate patient care and discharge planning. Both roles require RN licensure and certifications, but their daily responsibilities and work environments differ slightly, with Utilization Review Rns concentrating on review processes and Case Managers on patient advocacy and care coordination.

What is a utilization review RN?

A Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services and treatments provided to patients. They review medical records, collaborate with healthcare teams, and ensure that patient care meets established guidelines and payer requirements. Their role helps control costs, optimize care, and support compliance with healthcare regulations. Utilization Review RNs often work in hospitals, insurance companies, or managed care organizations.
What are the most commonly searched types of Utilization Review Rn jobs in Virginia? The most popular types of Utilization Review Rn jobs in Virginia are:
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Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Virginia as of August 2026, with employment types broken down into 1% As Needed, 85% Full Time, 12% Part Time, and 2% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $87,192 per year, or $41.9 per hour.

RN Director Case Management

Lifepoint Health

Danville, VA • On-site

$101K - $136K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 19 days ago

LifePoint Health rating

5.9

Company rating: 5.9 out of 10

Based on 272 frontline employees who took The Breakroom Quiz

758th of 887 rated healthcare providers

Job description

RN Director Case Management

Schedule: Monday-Friday 

Job Location Type: In Person

Your experience matters

Sovah Health is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Director joining our team, you are embracing a vital mission dedicated to making communities healthier. Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve.

More about our team

Our Case Management team focuses on serving the adult population in our community, maintaining a patient-to-staff ratio that is below the national average. Our collaborative approach to safe, effective discharge planning includes close coordination between a Utilization Review RN, Case Manager RN, and Social Worker-ensuring each patient receives comprehensive, personalized support throughout their care journey.

How you'll contribute

A Director who excels in this role:

  • Develops and implements departmental goals, plans, and standards consistent with the clinical,
    administrative, legal, and ethical requirements/objectives of the organization.

  • Directs and evaluates departmental operations, including patient care delivery, information technologies, service level determination, and complaint management, to achieve performance and quality control objectives.

  • Plans and monitors staffing activities, including hiring, orienting, evaluating, disciplinary actions, and continuing education initiatives.

  • Prepares, monitors, and evaluates departmental budgets, and ensures that the department operates in compliance with allocated funding. Coordinates and directs internal/external audits.

  • Creates and fosters an environment that encourages professional growth.

  • Integrates evidence-based practices into operations and clinical protocols.

Why join us

We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers:

  • Comprehensive Benefits: Multiple levels of medical, dental and vision coverage, tailored benefit options for part-time and PRN employees, and more.
  • Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.
  • Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.
  • Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).
  • Professional Development: Ongoing learning and career advancement opportunities.

More about Sovah Danville

Sovah Health - Danville is a 250-bed academic acute care hospital that has been offering exceptional care to the Danville community for over 120 years. We are proud to be recognized by the American College of Cardiology (Chest Pain Center & Heart Failure), American College of Surgeons' Commission on Cancer and Member of the Duke Heart Network and Duke Telestroke Network.

What we're looking for 

The right candidate will direct the department's activities and resources to achieve departmental and organizational objectives

Applicants should have a current RN VA or compact state license and possess a bachelor's degree in nursing. 

Additional requirements include:

  • Previous Case Management experience required.
  • Previously director or leadership experience preferred.

Annual range - $101,171 to $136,593 annually

EEOC Statement

Sovah Health - Danville is an Equal Opportunity Employer. Sovah Health - Danville is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment.

Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.We employ and provide care to people from all walks of life. We are committed to promoting healing, providing hope, preserving dignity and producing value with an inclusive workforce in which diversity is leveraged, respected, and reflective of the patients, family members, customers and team members we serve.

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About LifePoint Health

Sourced by ZipRecruiter

Lifepoint Health serves patients, clinicians, communities and partners across the healthcare continuum. Our diversified healthcare delivery network extends from coast to coast, consisting of community hospitals, rehabilitation and behavioral health hospitals, and additional sites of care.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Brentwood, TN, US

Year founded

1999

Social media

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