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Utilization Review Manager

Job in Arlington, Arlington County, Virginia, 22201, USA
Listing for: VHC Health
Full Time position
Listed on 2026-02-01
Job specializations:
  • Healthcare
    Healthcare Management
  • Management
    Healthcare Management
Salary/Wage Range or Industry Benchmark: 80000 - 100000 USD Yearly USD 80000.00 100000.00 YEAR
Job Description & How to Apply Below

Join to apply for the Utilization Review Manager role at VHC Health

Purpose & Scope

The Utilization Review Manager oversees the utilization review process, ensuring efficient and effective use of hospital resources, compliance with regulatory requirements, and optimal patient care.

  • Manage the utilization review team and processes.
  • Conduct reviews of patient care and resource utilization.
  • Collaborate with healthcare providers and hospital staff.
  • Ensure compliance with regulatory requirements and accreditation standards.
  • Analyze data to identify trends and opportunities for improvement.
  • Develop and implement strategies to optimize resource utilization and patient care.
Education

Bachelor's of Nursing is required

Experience

Three (3) years Utilization Review management experience; hospital and/or insurance considered.

Certification/Licensure

Licensed as a Registered Nurse with the Virginia Department of Health Professions is required, or Compact State Nursing License is required.

Seniority level

Mid-Senior level

Employment type

Full-time

Job function

Accounting/Auditing and Finance

Industries

Hospitals and Health Care

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