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Weekend Supervisor Utilization Management Jobs in Washington

Bartholomew House

Weekend Supervisor

Bethesda, MD · On-site

$18 - $23/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Address concerns immediately with resident or care manager and handle appropriately or refer to the Executive Director. Notify the Executive Director immediately following any concern or incident.

Bartholomew House

Weekend Supervisor

Bethesda, MD · On-site

$18 - $23/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Address concerns immediately with resident or care manager and handle appropriately or refer to the Executive Director. Notify the Executive Director immediately following any concern or incident.

Summit BHC

Utilization Assistant - Acute

Annapolis, MD · On-site

The Utilization Assistant provides support to all utilization review/management activities of the ... supervisor immediately to ensure timely resolution of problems. • Responds to telephone and ...

AmeriHealth Caritas

Clinical Care Reviewer UM

Washington, DC · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Role Overview Under the direction of a supervisor, the Utilization Management Reviewer evaluates ... Weekends and overtime based on business need Responsibilities * Conduct utilization management ...

Amerihealth Caritas

Clinical Care Reviewer UM

Washington, DC · Remote

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Role Overview Under the direction of a supervisor, the Utilization Management Reviewer evaluates ... Weekends and overtime based on business need Responsibilities * Conduct utilization management ...

MedStar Health

RN Team Lead Utilization Review

Clinton, MD · On-site

$89K - $162K/yr

General Summary of Position Supervises the daily activities of the Utilization Review Team. Manages daily assignment ensuring all UM tasks are completed each day. Collaborates with the physician ...

Complete Care at La Plata

RN Weekend Supervisor

La Plata, MD · On-site

$46/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

RN Supervisor (Registered Nurse) Starting Pay $46 & Up Part Time 2nd Shift Weekend Sat/Sun ... Observes care assignments, manages coverage needs, evaluates staff performance, educate & lead ...

Complete Care at La Plata

RN Weekend Supervisor

La Plata, MD

$46/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

RN Supervisor (Registered Nurse) * Starting Pay $46 & Up * Part Time 2nd Shift Every Other Weekend ... Observes care assignments, manages coverage needs, evaluates staff performance, educate & lead ...

MedStar Health

RN Team Lead Utilization Review

Clinton, MD · On-site

$89K - $162K/yr

Candidate must live in the DC/Baltimore region General Summary of Position Supervises the daily activities of the Utilization Review Team. Manages daily assignment ensuring all UM tasks are completed ...

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Weekend Supervisor Utilization Management information

What does a weekend supervisor in utilization management do?

A Weekend Supervisor in Utilization Management oversees the review and coordination of patient care services during weekends to ensure appropriate use of healthcare resources. They manage a team of utilization review staff, ensure compliance with policies, and facilitate communication between healthcare providers and insurance companies. Their role is critical in making timely decisions about patient admissions, continued stays, and discharges, focusing on quality care and cost efficiency. They also handle escalations and provide support to staff working outside of regular business hours.

What are the primary challenges a weekend supervisor in utilization management faces, and how can they be addressed?

Weekend Supervisors in Utilization Management often encounter challenges such as limited staff availability, high patient volume, and the need for rapid decision-making with less direct access to physicians or ancillary services. To address these, strong organizational skills, proactive communication, and the ability to prioritize urgent cases are essential. Supervisors should foster a collaborative atmosphere, leverage digital tools for efficient workflow, and ensure clear escalation protocols for complex cases, all while maintaining regulatory compliance and quality patient care.

What are the key skills and qualifications needed to thrive as a weekend supervisor in utilization management, and why are they important?

To thrive as a Weekend Supervisor Utilization Management, you need a comprehensive understanding of clinical guidelines, utilization review processes, and healthcare regulations, typically supported by a nursing degree (RN) or related clinical licensure. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of relevant accreditation standards (such as URAC or NCQA) are essential. Strong leadership, decision-making, and effective communication skills help navigate team dynamics and complex case reviews during weekend shifts. These skills ensure efficient resource management, compliance with healthcare standards, and consistent quality of care even outside regular business hours.

What is the difference between Weekend Supervisor Utilization Management vs Weekend Utilization Review Coordinator?

AspectWeekend Supervisor Utilization ManagementWeekend Utilization Review Coordinator
CredentialsTypically requires a healthcare-related license or certification (e.g., RN, LPN, or case management certification)Often requires similar healthcare credentials, such as RN or case management certification
Work EnvironmentSupervises utilization management staff, oversees case reviews, and ensures compliance during weekendsPerforms case reviews, evaluates medical necessity, and coordinates utilization decisions during weekends
Employer & IndustryHospitals, insurance companies, healthcare organizationsHospitals, insurance providers, healthcare organizations

The main difference is that the Weekend Supervisor Utilization Management role involves supervising staff and managing utilization processes, while the Weekend Utilization Review Coordinator focuses on conducting case reviews and making utilization decisions during weekends. Both roles require healthcare credentials and operate within similar environments, but their responsibilities differ in scope and leadership level.

What are popular job titles related to Weekend Supervisor Utilization Management jobs in Washington?

For Weekend Supervisor Utilization Management jobs in Washington, the most frequently searched job titles are:

What job categories do people searching Weekend Supervisor Utilization Management jobs in Washington look for?

The top searched job categories for Weekend Supervisor Utilization Management jobs in Washington are:

What cities in Washington are hiring for Weekend Supervisor Utilization Management jobs?

Cities in Washington with the most Weekend Supervisor Utilization Management job openings:

Weekend Supervisor Utilization Management jobs near you
Infographic showing various Weekend Supervisor Utilization Management job openings in Washington as of June 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution.

Director Utilization Management MedStar Family Choice

MedStar Health

Washington, DC • On-site

$120K - $238K/yr

Full-time

Re-posted 18 days ago

Medstar Health rating

7.8

Company rating: 7.8 out of 10

Based on 240 frontline employees who took The Breakroom Quiz

127th of 888 rated healthcare providers

Job description

About the Job
General Summary of Position
The Director of Utilization Management (UM) provides strategic and operational leadership for the health plan's centralized utilization management function across both plans. This role ensures appropriate evidence-based utilization of services while maintaining regulatory compliance improving quality outcomes and driving cost-effective delivery. Under a centralized clinical operation model the Director aligns UM process across plans standardizes workflows optimizes technology and integrates closely with Case Management Pharmacy Quality and Provider Relations to support enterprise-wide performance goals.
Primary Duties and Responsibilities
  • Leads enterprise-wide utilization management strategy across all health plans under a centralized clinical operation model.
  • Standardizes UM policies workflows and clinical criteria application to ensure consistency and scalability across markets.
  • Oversees prior authorization concurrent review retrospective review to ensure timely and compliant determinations.
  • Ensures compliance with state Medicaid NCQA CMS and contractual requirements including turnaround time standards.
  • Partners with medical directors to ensure appropriate clinical decision-making and consistent application of medical necessity criteria.
  • Develops and monitors UM performance dashboards including denial rates overturn rates length of stay and turnaround times.
  • Drives medical expense management initiatives by identifying utilization trends and implementing targeted interventions.
  • Collaborates with Case Management leadership to ensure seamless transitions between UM and care coordination functions.
  • Partners with pharmacy leadership to align utilization controls on high-cost drugs and specialty therapies.
  • Oversees hospital utilization management including inpatient admission appropriateness DRG optimization and reduction strategies.
  • Identifies and implements process improvement initiatives to increase operational efficiency and reduce variability.
  • Prepares for a lead regulatory audits accreditation reviews and corrective action plans related to UM functions.
  • Monitors and ensures compliance with evidence-based clinical criteria tools (e.g. InterQual ASAM) and internal policies.
  • Leads workforce planning and staffing models to ensure appropriate caseload distribution and productivity standards.
  • Supervises and develops UM managers and supervisors including performance evaluations and professional development.
  • Collaborates with Finance and Actuarial team to analyze utilization trends cost drivers and forecast medical expense impact.
  • Supports value-based payment models and alternative payment initiatives by aligning UM process with performance metrics.
  • Develops escalation and peer review process to manage complex or high-risk clinical determinations.
  • Ensures culturally competent and member- center decision-making balancing access quality and cost stewardship.
  • Provides executive-level reporting and strategic recommendation to the VP of Clinical Operations and senior leadership
    • Minimal Qualifications
    Education
    • Bachelor's degree Bachelor's degree in Nursing Social Work or related healthcare field required
    • Master's degree Master's degree in Nursing (MSN) Public Health (MPH) Healthcare Administration (MHA) Business Administration (MBA) or related field preferred
    Experience
    • 8-10 years years of managed care experience required and
    • 5-7 years Minimum 5 years utilization management leadership required and
    • Experience with centralized operations preferred and
    • Demonstrated experience in Medicaid managed care preferred
    Licenses and Certifications
    • RN - Registered Nurse - State Licensure and/or Compact State Licensure in MD/DC Upon Hire required
    Knowledge Skills and Abilities
    • Deep understanding of state Medicaid CMS and NCQA requirements
    • Experience in medical necessity criteria tools (InterQual)
    • Strong data analytics and financial acumen
    • Change management expertise
    • Excellent executive communication skills.

    This position has a hiring range of
    USD $120,702.00 - USD $238,222.00 /Yr.

    What Medstar Health employees say

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    About Medstar Health

    Sourced by ZipRecruiter

    MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation, and research. Our team of 32,000 includes physicians, nurses, residents, fellows, and many other clinical and non-clinical associates working in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest home health provider in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar Health is dedicated not only to teaching the next generation of doctors, but also to the continuing education, professional development, and personal fulfillment of our whole team. Together, we use the best of our minds and the best of our hearts to serve our patients, those who care for them, and our communities. It's how we treat people.

    Industry

    Health care and social assistance

    Company size

    10,000+ Employees

    Headquarters location

    Columbia, MD, US

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