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Director Chiropractic Utilization Review Jobs (NOW HIRING)

UHS

DIR - UTILIZATION REVIEW / MGMT

Oakland Park, FL

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

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

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

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

DIR - UTILIZATION REVIEW / MGMT

Oakland Park, FL · On-site

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 · On-site

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

DIR - UTILIZATION REVIEW / MGMT

Augusta, GA · On-site

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 ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Augusta, GA · On-site

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 ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Augusta, GA · On-site

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 ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Augusta, GA

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 ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Harahan, LA

River Oaks Hospital is seeking a dynamic and talented UTILIZATION REVIEW DIRECTOR to direct and serve within the Utilization Management team. Evaluates patient medical records to determine severity ...

UHS

Director of Utilization Review

Salt Lake City, UT · On-site

Responsibilities Salt Lake Behavioral Health is seeking a motivated and compassionate team player as our Director of Utilization Review. Salt Lake Behavioral Health is a private 118 bed freestanding ...

Fusion HCR

Utilization Review Nurse

Las Vegas, NV · On-site

Direct Hire - Utilization Review Nurse, this is an onsite position, working with our client in Acute Care. Overview Seeking an experienced Utilization Review Nurse (RN) to review patient admissions ...

UHS

Director, Utilization Review (UR)

Orem, UT · On-site

Responsibilities DIRECTOR, UTILIZATION REVIEW (UR) Join us in helping others rediscover their "hope." Since our establishment in 2011, we have been dedicated to providing exceptional and specialized ...

UHS

Director, Utilization Review (UR)

Orem, UT · On-site

Responsibilities DIRECTOR, UTILIZATION REVIEW (UR) Join us in helping others rediscover their "hope." Since our establishment in 2011, we have been dedicated to providing exceptional and specialized ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Augusta, GA

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 ...

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Director Chiropractic Utilization Review information

See salary details

$28.5K

$52.3K

$80.5K

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

As of Jul 17, 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

Director, Utilization Review

Cobalt Benefits Group LLC

Exeter, NH • On-site

$135K - $155K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 28 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