724 utilization jobs at 317 companies in Arlington, VA
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Utilization Reviewer
Largo, Maryland, United States
OnsiteFull Time
University of Maryland Medical System: Operates hospitals and clinics providing comprehensive medical healthcare services.
Active Maryland RN licensure (or compact eligibility) required; utilization/case management and acute care experience preferred; CPUR preferred; strong communication and analytical skills.
Commonwealth of Virginia: State government providing public services to Virginia residents.
Knowledge of inpatient psychiatric treatment, utilization management, third-party reimbursement, and regulatory requirements; ability to conduct chart and continued-stay reviews, communicate with clinicians and payers, produce reports, and write policies.
Luminis Health: Provides comprehensive hospital and healthcare services in Maryland.
3+ YOECurrent Maryland RN license, BSN (or ADN with equivalent experience; BSN to be completed within 5 years), 3 years acute care nursing, chart review and utilization management experience, EPIC proficiency.
LifeBridge Health: Provides hospital and comprehensive healthcare services in Maryland
Active RN license, utilization review and medical necessity knowledge, experience in utilization/case/care management, EHR proficiency, strong assessment, documentation, and communication skills.
Electronic Health Records (EHR), InterQual, MCG, utilization management software
Utilization Management Director - Inpatient (Hybrid)
Baltimore, Maryland, United States
$135k-$251k/yrHybridFull Time
CareFirst BlueCross BlueShield: Provides health insurance coverage and administrative healthcare services.
8+ YOE3+ MgmtRequires an active RN license, 8+ years clinical/UM experience with 3+ years management, proficiency with Guiding Care or similar, Microsoft Office, and knowledge of utilization management and regulatory requirements.
Guiding Care, Microsoft Word, Microsoft Excel, Microsoft PowerPoint
Director Utilization Management MedStar Family Choice
Washington, District of Columbia, United States
$121k-$238k/yrOnsiteFull Time
MedStar Health: Providing comprehensive healthcare services and patient care.
8+ YOE5+ MgmtProvides enterprise UM leadership; requires bachelor's in nursing/social work/related, RN licensure in MD/DC, 8+ years managed care experience, 5+ years UM leadership, InterQual experience, strong data and communication skills.
Director Utilization Management MedStar Family Choice
Washington, District of Columbia, United States
$121k-$238k/yrOnsiteFull Time
MedStar Health: Operates hospitals and provides diverse clinical healthcare services.
8+ YOE5+ MgmtRequires RN licensure in MD/DC, 8+ years managed care experience, 5+ years UM leadership, experience with InterQual, strong data/financial skills, and executive communication.
AI Utilization Specialist - Nuclear Systems Integration Division
Arlington, Virginia, United States
OnsiteFull Time
SAICNASDAQ: SAIC: Provides government and defense clients with technology and engineering services.
8+ YOEActive Top Secret clearance, BA+10 or MA+8 years experience, strong communication, familiarity with AI tools, workflow automation, GenAI.mil, and DoD processes; SharePoint experience preferred.
AI Utilization Specialist - Nuclear Systems Integration Division
Arlington, Virginia, United States
$160k-$200k/yrOnsiteFull Time
SAICNYSE: SAIC: Provides engineering, IT, and mission support services to government.
8+ YOEActive Top Secret clearance, BA+10 years or MS+8 years, familiarity with AI tools and GenAI.mil policy, strong communication and technical collaboration skills.
Verida: Manages non-emergency medical transportation for Medicaid and Medicare members.
2+ YOEActive RN licensed in DC/MD/VA, 2+ years clinical/utilization review or case management experience, strong clinical judgment, Medicaid knowledge, excellent communication, and ability to manage competing priorities.
American WaterNYSE: AWK: Provides regulated water and wastewater services to US customers.
Performs construction, operation and maintenance of water distribution systems; must work safely, handle chemicals, operate trucks and equipment, and perform physical outdoor tasks.
DC Water: Distributes drinking water and treats wastewater for District residents.
5+ YOEFive years experience operating and maintaining distribution, storage, pumping and sewer systems; high school diploma/GED; supervisory experience; ability to act as Confined Space Entry Site Supervisor; must obtain ABC, Collection Systems Operator II, and Distribution Systems Operator II within 18 months.
Stake Center Locating: Identifies and marks underground utility lines for excavation safety.
Entry-level role; 18+; high school diploma or equivalent; valid driver license and acceptable driving record; pass background and drug screen; able to walk up to 5 miles and lift up to 25 lbs (assisted lifting up to 75+ lbs).
Partner, AI-Enabled CDI, Care Management, and Utilization Management Transformation
Boston or Chicago or New York City or Washington or Nashville or United States
$250k-$350k/yrRemoteFull Time
Chartis: Strategic consulting and data analytics for the healthcare sector.
10+ YOEBachelor's required (advanced preferred), 10+ years in CDI/care management/utilization management or healthcare consulting, deep knowledge of DRGs/denial prevention, EHR workflows, AI-enabled solutions, and strong executive communication.
Senior Technical Infra Program Manager, DC Power Utilization Management
Seattle or Arlington or Herndon
$149k-$201k/yrOnsiteFull Time
AmazonNASDAQ: AMZN: Global online retail and cloud computing technology provider.
5+ YOE5+ years program or technical project management experience, bachelor's degree or equivalent, experience owning program strategy and delivery, strong communication, technical aptitude, and proficiency with Microsoft Office, Microsoft Project, and Microsoft SharePoint.
Microsoft Office, Microsoft Project, Microsoft SharePoint, Tableau, KanBan, Playbook, SQL
Samsung BiologicsKorea Exchange: 207940: Global contract development and manufacturing organization for biopharmaceuticals.
5+ YOEBS in engineering; 5+ years utilities/facility engineering in biopharma; knowledge of utility systems; project engineering; MS Project; PE preferred.
MS Project, Microsoft Word, Microsoft Excel, Microsoft PowerPoint
JRC Integrated Systems: Provides engineering and technology solutions for national defense missions.
5+ YOEBachelor's in engineering,5+ years utility/prime power experience,Top-Secret clearance with TS/SCI eligibility,experience conducting utility infrastructure assessments and interpreting engineering drawings.