Utilization Management RN: Lead Clinical Reviews
Job in
Charlottesville, Albemarle County, Virginia, 22904, USA
Listed on 2026-07-18
Listing for:
University of Virginia
Full Time
position Listed on 2026-07-18
Job specializations:
-
Nursing
Job Description & How to Apply Below
The Utilization Management RN at UVA Medical Center in Charlottesville provides leadership in the UM process, collaborates with physicians and care teams to promote regulatory compliance, and conducts initial concurrent and retrospective medical necessity reviews. This role analyzes complex clinical data to determine referral to external consultant review and uses UM tools appropriately.
It also handles appeals with external entities, supports the department's financial mission, and mentors
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