285 utilization management jobs at 155 companies in Fairfax, VA
3w
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Utilization Management CoordinatorNE
Glen Burnie, Maryland, United States
$41-$61/hr OnsitePart Time
3+ YOEActive Maryland RN license, graduation from accredited nursing program, BSN preferred, 3 years clinical experience, knowledge of utilization review and case management, ongoing professional development.
1mo
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Utilization Management Nurse
Annapolis or Lanham
$34-$55/hr HybridFull Time
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.
EPIC
1w
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Epic Tapestry Utilization Management
Boston or Chicago or New York City or Washington or Nashville
$85-$95/hr RemoteContract, Temporary
Design, configure, implement, and support Epic Tapestry Utilization Management workflows; ensure regulatory compliance; perform testing and documentation; partner with clinical and operational teams.
Epic, Epic Tapestry, Tapestry Care Link, SmartTools, SmartText
1mo
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Utilization Management Director - Inpatient (Hybrid)
Baltimore, Maryland, United States
$135k-$251k/yr HybridFull Time
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
1mo
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Director Utilization Management MedStar Family Choice
Washington, District of Columbia, United States
$121k-$238k/yr OnsiteFull Time
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.
InterQual
5d
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Utilization Review Nurse - Managed Care (673794)
Hanover or Maryland or Virginia or Pennsylvania or Delaware or Florida or United States
$40-$61/hr RemoteFull Time
3+ YOEUnencumbered Maryland or Compact State RN license, 3+ years acute care RN experience, 1+ year managed care or utilization review experience, and knowledge of InterQual criteria.
InterQual
2mo
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Senior Director, Complex Care Management and Utilization Management
Baltimore, Maryland, United States
RemoteFull Time
7+ YOESenior leadership in complex care or utilization management; travel across multiple markets; RN preferred; CCM/URAC credentials beneficial.
6d
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Utilization Review Manager (Behavioral Health Supervisor)
Fairfax, Virginia, United States
$85k-$148k/yr OnsiteFull Time
3+ YOE3+ MgmtMaster's degree in social work, psychology, counseling, or nursing plus 3 years clinical experience, or doctorate plus 1 year. Virginia licensure eligibility, driver's license, and supervisory expertise required.
Microsoft Excel, electronic documentation systems
1mo
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WGL - Manager, Project Management
Springfield or Canada
$124k-$180k/yr OnsiteFull Time
5+ YOE5+ MgmtBachelor's in engineering/project management or equivalent, PMP preferred; 5+ years project/program management (5+ years PMO leadership); utility/regulatory experience, financial acumen, stakeholder and risk management skills.
1mo
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Supervisor Work Management - WV & MD Work Management - Martinsburg Service Center
Martinsburg or Frederick or Mount Airy or Thurmont
OnsiteFull Time
5+ YOESupervisor with 5+ years related work experience in utility construction/maintenance, project management, leadership, Microsoft Office proficiency, WMI/GIS/SAP knowledge preferred, NESC/NEC awareness.
Microsoft Excel, Microsoft Word, Microsoft PowerPoint, WMI, GIS, CREWS, SAP
6d
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Construction Management Specialist
Arlington, Virginia, United States
$79k-$123k/yr OnsiteFull Time
3+ YOEHigh school, technical, or related college coursework plus 3 years of construction management, contract administration, or utility, stormwater, stream restoration, or site utility inspection experience. Valid driver's license required.
Microsoft Word, Microsoft Excel, Microsoft Access
3d
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UTILITY TECHNICIAN II (WATER)
Herndon, Virginia, United States
$30-$38/hr OnsiteFull Time
3+ YOE2+ MgmtHigh school diploma/GED and 3 years of water utilities or related experience. Requires Class B CDL, tanker endorsement, Virginia Class V Waterworks Operator License, and safety certifications.
AMR, AMI
1mo
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Senior Technical Infra Program Manager, DC Power Utilization Management
Seattle or Arlington or Herndon
$149k-$201k/yr OnsiteFull Time
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
3w
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Registered Nurse Utilization Review
Baltimore, Maryland, United States
$81k-$116k/yr HybridFull Time
Maryland RN credential required; diploma from accredited nursing school or equivalent licensure; experience in utilization/case management preferred; knowledge of clinical documentation and payer regulations.
3w
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Case Management Director
Fredericksburg, Virginia, United States
OnsiteFull Time
3+ YOELead day-to-day case management operations; 3+ years hospital-based case management including utilization review and discharge planning; CCM/ACMTM preferred; RN license required if applicable; bachelor\u0002s degree (BSN for nurses).
3w
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Senior Asset Management Consultant
Virginia Beach or Hanover
$100k-$170k/yr HybridFull Time
7+ YOE7+ years consulting or municipal utility experience, B.S. in engineering/MIS/engineering management, IAM/PE/PMP preferred, experience with GIS, BI tools, CMMS, Microsoft Project.
GIS, Power BI, Tableau, CMMS, Microsoft Project
1mo
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Manager for Case Management- Bayview Location
Baltimore, Maryland, United States
$95/hr OnsiteTemporary
5+ YOE1+ MgmtCurrent RN licensure in MD, CPR required, ACM or CCM certification within 2 years, 5+ years case management experience, 1+ year leadership experience, knowledge of utilization management and Medicare regulations.
2w
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Vice President of Software Engineering for Utilization Management
Eden Prairie or Minneapolis or Washington or United States
$200k-$344k/yr RemoteFull Time
10+ YOE5+ Mgmt10+ years progressive software engineering leadership, 5+ years platform modernization and cloud migration leadership, healthcare/UM experience preferred, AI and workforce transformation experience, executive stakeholder management.
Optum Care Management (OCM), AI, machine learning, FHIR, HL7, EDI 278, EDI 275, DevOps
1mo
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Referral Management (Non-Nurse) Reviewer
Bethesda, Maryland, United States
$24/hr OnsiteFull Time
2+ YOEAssociate's degree, 2+ years in utilization/referral/authorization/claims processing, U.S. citizenship with ability to obtain Public Trust clearance, knowledge of InterQual/Milliman/SRGs, familiarity with MHS/TRICARE/HIPAA, and Microsoft Office proficiency.
Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Microsoft Access, Microsoft Outlook, MHS-GENESIS, Genesis Work Lists, External Provider Referral Online (EPRO)
1mo
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Water/Wastewater Project Manager - Utility Management
Fairfax or Richmond
$130k-$167k/yr OnsiteFull Time
10+ YOE5+ MgmtBachelor's in engineering required; 10+ years water/wastewater experience, 5+ years project management; Virginia PE required (reciprocity for other states within one year); experience in water/wastewater modeling; strong communication and leadership; programming/scripting preferred.