ZipRecruiter

Log In

1

Utilization Jobs in Virginia (NOW HIRING)

Evolent

Cardiology Physician

Arlington, VA · On-site

$407K - $460K/yr

As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients lives, in a non-clinical ...

Evolent

Cardiology Physician

Arlington, VA · On-site

$407K - $460K/yr

As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients lives, in a non-clinical ...

previous page

Showing results 41-60

All JobsUtilization JobsUtilization Jobs in Virginia

Utilization information

See Virginia salary details

$21

$41

$68

How much do utilization jobs pay per hour?

As of Aug 19, 2026, the average hourly pay for utilization 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 specialist?

Utilization specialists are professionals who review and evaluate the necessity, appropriateness, and efficiency of the use of healthcare services, procedures, and facilities. They work closely with healthcare providers, insurance companies, and patients to ensure that care is delivered according to established guidelines and that resources are used effectively. Their goal is to help manage costs while ensuring patients receive the appropriate level of care.

What are some of the common challenges faced by utilization review specialists when assessing medical necessity of services?

Utilization Review Specialists often encounter the challenge of balancing patient advocacy with cost-effective care. They must stay updated on evolving insurance policies and clinical guidelines, which can be complex and change frequently. Additionally, coordinating with physicians and healthcare staff to obtain necessary documentation and clarifying treatment plans can be time-consuming. Strong communication skills and attention to detail are essential to ensure timely and accurate reviews, while also maintaining positive working relationships with clinical teams.

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

To thrive as a Utilization Review Specialist, you need a background in healthcare (often as an RN or LPN/LVN), strong analytical skills, and knowledge of insurance and medical necessity criteria. Familiarity with utilization management software, ICD-10/CPT coding, and regulatory guidelines like Medicare and Medicaid is typically required. Excellent attention to detail, critical thinking, and effective communication skills set top performers apart in this role. These abilities are crucial to accurately evaluating patient care needs, ensuring regulatory compliance, and optimizing resource use within healthcare organizations.

What is the difference between Utilization vs Resource Coordinator?

AspectUtilizationResource Coordinator
Primary FocusMeasuring and optimizing how staff time is usedManaging and assigning resources for projects
Required CredentialsOften no specific credentials, but industry experience helpsTypically requires organizational or project management skills
Work EnvironmentCorporate, healthcare, or consulting firmsProject teams, staffing agencies, or departments
Common UsageTracking staff utilization ratesAllocating resources to projects or tasks

Utilization focuses on measuring how effectively staff time is used, often to improve productivity. Resource Coordinator involves actively managing and assigning resources to ensure project needs are met. While related, utilization is more about analysis, and resource coordination is about execution and management.

How to become a utilization reviewer?

To become a utilization reviewer, candidates typically need a background in healthcare, nursing, or a related field, along with knowledge of medical coding and insurance policies. Relevant certifications such as Certified Professional Coder (CPC) or Certified Medical Reimbursement Specialist (CMRS) can enhance job prospects. Strong analytical skills and attention to detail are essential for reviewing medical records and determining appropriate service utilization.

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

The most popular types of Utilization jobs in Virginia are:

What cities in Virginia are hiring for Utilization jobs?

Cities in Virginia with the most Utilization job openings:

Utilization jobs near you
Infographic showing various Utilization job openings in Virginia as of August 2026, with employment types broken down into 2% As Needed, 79% Full Time, 17% Part Time, and 2% Contract. Highlights an 91% Physical, 2% Hybrid, and 7% Remote job distribution, with an average salary of $87,192 per year, or $41.9 per hour.

Healthcare Administrator - Richmond (Operations & Compliance Focus)

Civitas Health Services

Sandston, VA • On-site

$51K - $66K/yr

Full-time

Posted 19 days ago

Job description

About the OpportunityCivitas Health Services is seeking an organized, analytical, and mission-driven Healthcare Administrator to oversee operations for our Richmond location. This position combines healthcare administration with a strong focus on operational compliance, utilization management, audit readiness, budgeting, and performance reporting.Salary: $51,500 - $66,500 annually (DOE)What You'll DoLead daily administrative operations.Coordinate and respond to audits while maintaining continuous audit readiness.Track utilization, productivity, KPIs, and operational performance.Support budgeting, financial oversight, and operational reporting.Monitor documentation compliance and implement quality improvements.Partner with clinical and executive leadership to improve operational outcomes.Qualifications3+ years of healthcare operations experience.Experience with compliance, utilization management, or audit support.Strong Excel and reporting skills.Behavioral health experience preferred.Experience with Medicaid/MCOs is a plus.BenefitsMedical, Dental, VisionLife InsuranceShort- and Long-Term DisabilityCEU ReimbursementProfessional Development SupportLeadership Growth PathwayEqual Employment OpportunityCivitas Health Services, Inc. is proud to be an Equal Opportunity Employer. We welcome qualified applicants from all backgrounds.