1mo
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Utilization Assistant
Williamsburg, Virginia, United States
OnsiteFull Time
Supports utilization review and insurance verification, conducts benefit checks and pre-certifications, reviews medical records for level-of-care appropriateness, coordinates with payers and business office, and documents utilization management activities.
2w
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Supervisor, Utilization Management
Alaska or Arkansas or Arizona or Colorado or Florida or Hawaii or Iowa or Idaho or Illinois or Kansas or Louisiana or Maryland or Minnesota or Missouri or Montana or Nebraska or Nevada or New Mexico or North Carolina or North Dakota or Oklahoma or Oregon or South Carolina or South Dakota or Tennessee or Texas or Utah or Virginia or District of Columbia or Washington or Wisconsin or Wyoming or Phoenix
$101k-$107k/yr RemoteFull Time
3+ YOE3+ MgmtActive RN license, 3+ years healthcare experience, 3+ years supervisory experience, 2+ years utilization review/case management, U.S. citizenship and favorable DoD background investigation required.
InterQual, Microsoft Office, Microsoft Word, Microsoft Outlook, TriWest Intranet, Internet, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders, Current Procedural Terminology, Healthcare Common Procedural Coding System, American Dental codes
3w
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Utilization Management Analyst
Fairfax County, Virginia, United States
$71k/yr OnsiteFull Time
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.
Microsoft Word, Microsoft Excel, AVATAR, EHR
4d
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Utilization Review Specialist (FLEXI)
Chesapeake, Virginia, United States
$32-$44/hr OnsitePart Time
2+ YOECurrent unrestricted LPN license in Virginia or compact state, 2 years clinical healthcare experience, familiarity with utilization review/case management, strong documentation and communication skills.
2mo
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Director of Utilization Management
Danville, Virginia, United States
OnsiteFull Time
3+ YOEBachelor's in human services; Master's preferred. 3-5 years in utilization review and case management. RN/LCSW/LPC/LMFT/LCP in Virginia required.
2w
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Utilization Review/Office Manager
Richmond, Virginia, United States
$22-$26/hr OnsiteFull Time
Experience with utilization review or office management preferred; strong organization, communication, documentation, and problem-solving skills; ability to handle sensitive information and support administrative and review workflows.
3w
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Utilization Review Nurse RN - PRN
Baltimore or District of Columbia or Maryland or Pennsylvania or Virginia or West Virginia
$50/hr OnsitePart Time
2+ YOECurrent Maryland RN or compact multistate license, ADN required (BSN preferred), BLS as applicable, minimum 2 years acute inpatient ED utilization review experience, residency in DC/MD/PA/VA/WV required.
1w
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Behavioral Healthcare Utilization Review Spec
Lynchburg, Virginia, United States
$46k-$74k/yr OnsiteFull Time
2+ YOEBachelor's in human services (Master's preferred),2+ years CQI/utilization review experience (managed care preferred),knowledge of DSM‑5/CPT/ICD‑10 and Medicaid/MCO rules,EMR and Microsoft Office proficiency,valid driver's license,ability to travel and work modified schedules.
Microsoft Office, EMR
3mo
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Billing/Utilization Specialist
Richmond, Virginia, United States
$17-$23/hr OnsiteFull Time
2+ YOEBachelor's degree in business, health care administration, accounting, or related field; 2+ years medical billing experience; proficient with billing software/EMR; strong communication and multitasking.
Billing software, Electronic medical records (EMR), Insurance claim submission
2mo
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Utilization Management Program Manager-RN
Arizona or Arkansas or Connecticut or Florida or Georgia or Idaho or Indiana or Iowa or Kansas or Kentucky or Louisiana or Michigan or Mississippi or Missouri or Montana or Nebraska or Nevada or New Hampshire or New Mexico or North Carolina or Oklahoma or Oregon or Pennsylvania or South Carolina or South Dakota or Tennessee or Texas or Utah or Virginia or West Virginia or Wisconsin
RemoteFull Time
5+ YOEUnencumbered Oregon RN within 90 days, 1 year clinical nursing plus 4 years health-plan utilization management, experience with managed care, data analysis, quality management, and electronic documentation.
Microsoft Office, EPIC, Clinical Care Advanced
3d
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Utilization Management Nurse Consultant
Virginia, United States
$26-$69/hr RemoteFull Time
3+ YOEActive Virginia or multi-state compact RN license, 3+ years clinical nursing, ADN required, BLS/CPR required, ACLS preferred, strong clinical decision-making and computer proficiency.
2w
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SPACE UTILIZATION COORDINATOR (1548626)
Virginia, United States
$55k-$62k/yr OnsiteFull Time
1+ YOEHigh school diploma or equivalent; 1+ year conference or corporate setting experience preferred; strong administrative, problem-solving, multitasking, and communication skills; customer-focused and detail-oriented.
Google Suite, EMS, Delphi
22h
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AI Utilization Specialist - Nuclear Systems Integration Division
Arlington, Virginia, United States
OnsiteFull Time
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.
GenAI.mil, SharePoint
22h
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AI Utilization Specialist - Nuclear Systems Integration Division
Arlington, Virginia, United States
$160k-$200k/yr OnsiteFull Time
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.
SharePoint
1w
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Utilization Management Behavioral Health Professional
Kentucky or Ohio or West Virginia or Virginia or Indiana or Illinois or Tennessee or Missouri
$65k-$89k/yr RemoteFull Time
3+ YOEMust reside in KY or contiguous counties, Bachelor's in nursing or Master's in Human Services plus professional license, 3+ years clinical experience, intermediate Microsoft Office skills.
Microsoft Teams, Microsoft Excel, Microsoft PowerPoint, Microsoft Outlook, Microsoft Word
1mo
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Utilization - REACH Intensive ($2,500 Sign on Bonus)
Radford, Virginia, United States
$37k/yr OnsiteFull Time
Bachelor's degree in psychology, counseling, social work, or related human services field; QMHP-E status required; experience with authorizations for behavioral health services; bilingual skills a plus.
1w
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Technician, Maintenance & Relief Operator
Cape Charles, Virginia, United States
$27-$32/hr OnsiteFull Time
0+ YOEHigh school diploma, 0–2+ years mechanical or utility experience preferred, valid driver license or ability to obtain required licenses, basic mechanical, safety, sampling and troubleshooting skills.
1mo
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Clinical Coordinator - Utilization Review
Hampton, Virginia, United States
$61k/yr OnsiteFull Time
3+ YOEMaster's in Human Services and 3 years' behavioral health experience including utilization management; ability to conduct clinical reviews, face-to-face assessments, bed management, and prepare utilization reports.
1w
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Wastewater Collection Utility Worker I/II/III/IV
Williamsburg, Virginia, United States
$41k-$89k/yr OnsiteFull Time
High school diploma or equivalent; valid Virginia driver’s license obtainable within 30 days; ability to obtain CDL permit and license per level; must meet respiratory protection program requirements and pass required training/exams; knowledge of trench safety, confined space, and heavy equipment operation.
1w
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Lead Operator
Onancock, Virginia, United States
$77k-$100k/yr OnsiteFull Time
4+ YOESupervise wastewater plant operations, 4 years wastewater experience, HS diploma/GED or Associate's in relevant field or VA Class I operator; valid driver's license; obtain VA Class I within 4 years and Water Quality QA/QC within 6 months.
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