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Director Chiropractic Utilization Review Jobs (NOW HIRING)

Cobalt Benefits Group LLC

Director, Utilization Review

Exeter, NH · On-site

$135K - $155K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Director of Utilization Review is responsible for the strategic leadership, operational execution, and regulatory compliance of the Utilization Review (UR) program. This role ensures clinically ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Oakland Park, FL · On-site

  • Medical

  • Dental

  • Vision

  • PTO

The Director of Utilization Management is also responsible for ensuring that the utilization review process meets the integrity standards set by FLBHC and UHS. The Director: interfaces with clinical ...

UHS

Director of Utilization Review

Gulfport, MS

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Director of Utilization Review : will assume responsibility for the functioning of the Utilization Review Department and provide utilization review services in a manner consistent with the ...

UHS

Director of Utilization Review

Gulfport, MS · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Director of Utilization Review : will assume responsibility for the functioning of the Utilization Review Department and provide utilization review services in a manner consistent with the ...

UHS

Director of Utilization Review

Gulfport, MS

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Director of Utilization Review : will assume responsibility for the functioning of the Utilization Review Department and provide utilization review services in a manner consistent with the ...

UHS

Director of Utilization Review

Gulfport, MS · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Director of Utilization Review : will assume responsibility for the functioning of the Utilization Review Department and provide utilization review services in a manner consistent with the ...

TUBA CITY REGIONAL

Utilization Review

Tuba City, AZ · On-site

RN - Utilization Review Excel is seeking highly skilled healthcare professionals for travel ... Provide direct patient care in accordance with healthcare facility policies and procedures.

UHS

DIR - UTILIZATION REVIEW / MGMT

Augusta, GA · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...

Enlyte

Utilization Reviewer 2

Tampa, FL

$59K - $76K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

Registered Nurse (RN) or chiropractor with a valid license in the state of Florida. * Minimum of 2 years of utilization review experience; or an advanced degree without experience. * Knowledge of ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Augusta, GA · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...

Prime Time Healthcare

Utilization Review

Baltimore, MD · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

Now Hiring: RN Utilization Review - Baltimore, MD Are you a passionate RN professional looking for ... Competitive compensation and weekly direct deposit * Compliance support specialist & onboarding ...

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Director Chiropractic Utilization Review information

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$28.5K

$52.3K

$80.5K

How much do director chiropractic utilization review jobs pay per year?

As of Aug 14, 2026, the average yearly pay for director chiropractic utilization review in the United States is $52,327.00, according to ZipRecruiter salary data. Most workers in this role earn between $42,000.00 and $57,000.00 per year, depending on experience, location, and employer.

What is the difference between Director Chiropractic Utilization Review vs Chiropractic Utilization Review?

AspectDirector Chiropractic Utilization ReviewChiropractic Utilization Review
CredentialsTypically requires advanced degrees, certifications, and leadership experienceRequires chiropractic license and certification, with less emphasis on leadership
Work EnvironmentOversees teams, manages policies, and strategic planningPerforms case reviews, evaluates claims, and ensures compliance
Employer & Industry UsageUsed in insurance companies, healthcare organizations, and large clinicsCommonly employed in insurance companies, third-party administrators, and healthcare providers

The main difference is that the Director Chiropractic Utilization Review holds a leadership role overseeing review teams and policies, while Chiropractic Utilization Review focuses on performing case evaluations and claims assessments. The director's role involves strategic management, whereas the review role is more operational and case-specific.

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Director Chiropractic Utilization Review jobs near you
Infographic showing various Director Chiropractic Utilization Review job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $52,327 per year, or $25.2 per hour.

Director, Utilization Review

Cobalt Benefits Group LLC

South Burlington, VT • On-site

$135K - $155K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 26 days ago

Job description

Description:

The Director of Utilization Review is responsible for the strategic leadership, operational execution, and regulatory compliance of the Utilization Review (UR) program. This role ensures clinically sound, timely, and compliant medical necessity determinations across all lines of business, while driving integration across Claims, Appeals, Stop Loss, and vendor partners. The position also advances technology-enabled utilization management, interoperability, and population health strategies in alignment with CBG’s operational and client objectives.


Clinical & Operational Leadership:

  • Provide leadership and oversight of the Utilization Review department
  • Ensure consistent, evidence-based medical necessity determinations
  • Establish and enforce clinical guidelines, documentation standards, and review protocols
  • Maintain alignment with MCG guidelines and internal clinical governance standards

Claims, Appeals & Stop Loss Integration:

  • Ensure seamless alignment between UR and Claims workflows
  • Provide clinical expertise and documentation support for Appeals processes
  • Partner with Stop Loss teams on high-cost claim reviews and determinations
  • Promote end-to-end workflow efficiency across clinical and administrative functions

Regulatory Compliance & Audit Readiness:

  • Ensure compliance with CMS, state, ERISA/non-ERISA, and accreditation requirements
  • Maintain audit-ready documentation and defensible clinical decisions
  • Oversee development and accuracy of denial and determination letters
  • Partner with Compliance and Legal to ensure regulatory alignment across all lines of business

Technology, Interoperability & Data Strategy:

  • Drive automation and digital workflow enhancements within UR
  • Enable interoperability across UR, Claims, Appeals, and vendor systems
  • Support real-time data exchange (EDI, integration platforms)
  • Leverage analytics to inform utilization trends, clinical outcomes, and population health initiatives

Quality, Training & Performance Management:

  • Establish quality assurance programs, audit processes, and performance standards
  • Develop and deliver training programs for clinical and operational staff
  • Implement dashboards and KPIs to measure productivity, compliance, and outcomes
  • Foster a culture of continuous improvement and accountability
Requirements:
  • Active Registered Nurse (RN) license
  • Minimum 5+ years of Utilization Review leadership experience
  • Strong knowledge of MCG guidelines, regulatory standards, and claims integration
  • Preferred experience within a TPA or health plan environment
  • Preferred familiarity with clinical platforms, workflow automation, and interoperability tools

Why Join Cobalt Benefits Group?

Cobalt Benefits Group is a trusted third-party administrator specializing in self-funded benefit plans. With over 30 years of experience and 180+ employees, we support employers through customized health plan administration, claims management, and specialized programs including FSAs, HSAs, COBRA, and retiree billing.

After a 60-day waiting period, full-time employees are eligible for a comprehensive benefits package, including:

  • Medical, dental, and vision coverage with employer HSA contributions
  • Company-paid life, AD&D, and disability insurance
  • 401(k) with up to a 6% employer match
  • Generous paid time off, sick time, and 10+ paid holidays
  • Flexible Spending Accounts
  • A collaborative culture with regular company events

Cobalt Benefits Group is an Equal Employment Opportunity Employer


Cobalt Benefits Group participates in E-Verify to confirm the employment eligibility of all new hires.