Utilization Review Manager
Company: VHC Health
Location: Arlington
Posted on: February 13, 2026
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Job Description:
Job Description Job Description Overview If you are a Registered
Nurse who has strong hospital Utilization Review (UR) experience
and are ready to take the next step into a leadership role, we
would love to hear from you! This position offers a hybrid schedule
, with most work performed remotely, offering both flexibility and
impact. In this role, you will lead a high-performing team of seven
experienced UR nurses who complete daily reviews of newly admitted
Observation and Inpatient charts to ensure accurate patient status
assignment and complete documentation to support timely insurance
reimbursement. The team consistently maintains a low denial rate,
reflecting their expertise and collaboration. As UR Manager, you
will also stay hands-on by managing a partial review assignment
using the Xsolis/Dragonfly system, while participating in
higher-level meetings such as Two-Midnight and denial review
discussions. You’ll work closely with a supportive and engaged
physician group through Med-Metrix and our internal medical
director team. Reviews span all patient populations, from short
stay and ICU to behavioral health units, making this a dynamic and
rewarding leadership opportunity. Come join a hospital dedicated to
you and your career! VHC Health is a 453-bed not-for-profit
Hospital and teaching facility that has been delivering high
quality care to the Washington, DC metropolitan area for over 75
years. Recent accomplishments include recognition by Newsweek as a
2025 " World's Best Hospital" and VHC becoming the Washington
Commanders Football provider for women's health. VHC Health is a
designated Level II Trauma Center and a recognized Magnet Facility
by the American Nurses Credentialing Center. At VHC Health, we are
always striving to provide continued excellence and growth for our
employees as well as top notch care for our patients and that is
made clear with our recent accomplishments! Responsibilities Pay &
Benefits: Commensurate with experience. Team members are eligible
to receive benefits on the first day of the month following the
date of hire, with 30 days to apply for benefits of choice.
Employee-Led Engagement and Wellness Committee dedicated to make
work a fun and healthy place to work Annual Employee Survey – Your
Voice is Heard at VHC! Paid Major Holidays Generous Paid Time Off /
Vacation / Sick Time Health Insurance Dental Insurance Tuition
Reimbursement Student Loan Repayment Career Counseling, Leadership
Development and Training Clinical and Research Pathways Eligible
Annual Merit Review and Merit Increases Employee Assistance Program
(EAP) Flexible Spending Accounts (FSA) Health Savings Account (HSA)
Health Fitness & Education Class Discounts Employee Wellness
Benefits Hospital Discount for Employees and Family VHC Health
Outpatient Pharmacy VHC Retirement Program Workforce Enhancement
Program Work/Life Discounts Program Free onsite parking Commuter
Benefits Family Leave 401(k) Match and much more! Qualifications
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. The Utilization Review Manager will: 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.
Keywords: VHC Health, Richmond , Utilization Review Manager, Healthcare , Arlington, Virginia
