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Utilization Review Jobs in Virginia (NOW HIRING)

UHS

UTILIZATION COORDINATOR

Danville, VA

... review and respond to concerns expressed by customers. Together with the appropriate Department ... · Assist in preparing Utilization Review Reports as necessary. · Coordinates and makes ...

UHS

Director of Utilization Management

Danville, VA · On-site

$79K - $95K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Three to five years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, ... or LCP in Virginia required. EEO Statement All UHS subsidiaries are committed to providing an ...

UHS

UR COORDINATOR

Danville, VA · On-site

$26 - $35/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... Utilization Review Reports as necessary. • Coordinates and makes Retrospective Appeals to third party payers. • Meets weekly with Administrator on appropriate issues. • Other duties as assigned ...

GQR Global Markets

RN Case Manager

Williamsburg, VA · On-site

$1.9K - $1.9K/wk

  • Medical

  • Dental

  • Vision

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Williamsburg, Virginia Start Date: August 24, 2026 Profession: Registered Nurse (RN) Facility: Estimated Pay ...

New

Maximus

Consultant - Medical (Case Reviewer 2)

VA · On-site +1

  • Medical

  • Life

  • Retirement

  • PTO

... Utilization Review experience. - Medicare Set-Aside Arrangement experience. Additional Knowledge of: - Healthcare Common Procedure Coding System (HCPCS) coding practices. - Medicare coverage ...

Acentra Health

Physician Medical Reviewer-PRN

Mclean, VA · On-site

  • Medical

  • Dental

  • Retirement

Must have Utilization Review experience in Behavioral Health Services. * Working knowledge of quality assurance and utilization review is required. * 3+ years of clinical practice. * Experience with ...

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Showing results 21-40

All JobsUtilization Review JobsUtilization Review Jobs in Virginia

Utilization Review information

See Virginia salary details

$21

$41

$68

How much do utilization review jobs pay per hour?

As of Aug 18, 2026, the average hourly pay for utilization review 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.

What is a utilization review?

A Utilization Review (UR) job involves assessing the medical necessity, efficiency, and appropriateness of healthcare services. UR professionals, often nurses or healthcare specialists, review patient records, insurance claims, and treatment plans to ensure they meet industry standards and payer requirements. They work with healthcare providers, insurance companies, and regulatory agencies to optimize care while controlling costs. Their goal is to balance quality patient care with cost-effective resource utilization.

What does a utilization review do?

A typical day in Utilization Review involves reviewing patient medical records, evaluating the necessity and appropriateness of proposed treatments or services, and documenting recommendations based on clinical criteria and insurance policies. Utilization Review specialists often collaborate closely with physicians, nurses, and insurance representatives to gather additional information and clarify cases. While much of the role is desk-based and may include remote work options, it requires regular communication with both clinical and administrative teams. This position offers variety and challenge, as no two cases are exactly alike, and there are often opportunities to advance into supervisory or quality improvement roles within the department.

What are the key skills and qualifications needed to thrive in utilization review?

To thrive in Utilization Review, professionals typically need a background in nursing or healthcare, strong clinical assessment capabilities, and a thorough understanding of medical guidelines and insurance regulations. Familiarity with electronic medical records (EMR) systems and utilization management software, and often certification such as Certified Utilization Review Specialist (CURN), are important. Excellent critical thinking, attention to detail, and strong communication skills enable effective case evaluation and collaboration with healthcare teams. These skills and qualifications ensure objective, accurate decisions that support cost-effective, quality patient care within compliance standards.

How do I get into a utilization review?

To become a utilization review specialist, typically a healthcare or related degree such as nursing, health administration, or social work is required. Certification in case management or utilization review, like the Certified Professional in Healthcare Quality (CPHQ), can enhance job prospects, and strong analytical and communication skills are essential for success in the role.

Is utilization review a stressful job?

Utilization review is a healthcare role that involves evaluating medical necessity and appropriateness of services, often under strict deadlines and documentation requirements. The job can be stressful due to high workload, the need for accuracy, and managing complex cases, but stress levels vary based on 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 jobs in Virginia?

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

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

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

What cities in Virginia are hiring for Utilization Review jobs?

Cities in Virginia with the most Utilization Review job openings:

Utilization Review jobs near you
Infographic showing various Utilization Review job openings in Virginia as of August 2026, with employment types broken down into 82% Full Time, and 18% Part Time. Highlights an 94% In-person, and 6% Remote job distribution, with an average salary of $87,192 per year, or $41.9 per hour.

Utilization - REACH Intensive ($2,500 Sign on Bonus)

New River Valley Community Services

Radford, VA

Full-time

PTO

Re-posted 29 days ago

New River Valley Community Services rating

3.6

Company rating: 3.6 out of 10

Based on 7 frontline employees who took The Breakroom Quiz

Job description

Our REACH team is growing and searching for our next Utilization and Training Specialist! In this position, you will ensure all utilization management and training processes are completed as needed to ensure quality services are provided. While working for NRVCS, you are subject to our generous PTO package, and benefits plan to best suit your needs. Come join this exciting team today!

**$2,500 Sign on Bonus**

Starting Salary: $36,980.55-$37,442.81-Depending on Experience

Education/Experience Required:

  • Graduation from an accredited university with at least a bachelor's degree in psychology, counseling, social work, or a related human services field is required.
  • Virginia Board of Counseling QMHP-E status is required, QMHP-A and QMHP-C is preferred.
  • Experience in submitting and tracking authorizations for insurance payments for behavioral health services is preferred.

Additional compensation will be considered for any new employees who speak multiple languages. 

What New River Valley Community Services employees say

Pay

Hours and flexibility

Workplace

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