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Director Of Utilization Management Jobs (NOW HIRING)

UHS

Director of Utilization Review

Gulfport, MS

The Director of Utilization Review : will assume responsibility for the functioning of the ... Minimum of 2 years clinical experience and 1 year of management experience with case management and ...

UHS

Director of Utilization Review

Gulfport, MS · On-site

The Director of Utilization Review : will assume responsibility for the functioning of the ... Minimum of 2 years clinical experience and 1 year of management experience with case management and ...

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$18K

$52.3K

$84K

How much do director of utilization management jobs pay per year?

As of Jul 8, 2026, the average yearly pay for director of utilization management in the United States is $52,322.00, according to ZipRecruiter salary data. Most workers in this role earn between $40,000.00 and $60,000.00 per year, depending on experience, location, and employer.

What are some common challenges faced by a Director of Utilization Management and how can they be addressed?

A Director of Utilization Management often navigates challenges such as balancing cost containment with quality patient care, managing interdisciplinary teams, and keeping up with changing healthcare regulations. Successfully addressing these challenges requires strong communication skills, the ability to analyze and implement evidence-based utilization protocols, and fostering a collaborative environment among clinical staff, case managers, and administrative teams. Staying engaged with ongoing education and industry best practices also helps in proactively adapting to regulatory updates and evolving patient needs.

What is the difference between Director Of Utilization Management vs Utilization Review Nurse?

AspectDirector Of Utilization ManagementUtilization Review Nurse
CredentialsTypically requires a nursing license, healthcare management experience, and sometimes a master's degreeRegistered Nurse (RN) license, often with certifications in case management or utilization review
Work EnvironmentAdministrative setting, overseeing utilization management teams and policiesClinical setting, performing patient chart reviews and assessments
Employer & IndustryHospitals, insurance companies, healthcare systemsHospitals, insurance companies, healthcare providers
Primary FocusStrategic oversight of utilization management processes and complianceClinical review of patient cases to determine medical necessity

The main difference is that the Director Of Utilization Management focuses on overseeing and managing utilization strategies at an organizational level, while the Utilization Review Nurse conducts clinical reviews to assess individual patient cases. Both roles require healthcare credentials, but their responsibilities and work environments differ significantly.

What are the key skills and qualifications needed to thrive as a Director of Utilization Management, and why are they important?

To thrive as a Director of Utilization Management, you typically need a strong background in healthcare administration, case management, and managed care principles, often supported by a clinical degree (RN, LCSW, or equivalent) and relevant experience. Familiarity with utilization review software, health information systems, and certifications like CCM (Certified Case Manager) or ACM (Accredited Case Manager) are highly valued. Leadership, strategic decision-making, and excellent interpersonal skills help drive team performance and facilitate collaboration across departments. These competencies are vital to ensuring effective resource use, regulatory compliance, and high-quality patient outcomes.

What does a Director of Utilization Management do?

A Director of Utilization Management oversees the processes that ensure patients receive appropriate, efficient, and medically necessary care within a healthcare organization. They lead teams that review patient cases, manage resource use, and implement policies to optimize healthcare quality and cost-effectiveness. This role often involves coordinating with physicians, insurance providers, and other healthcare professionals to ensure compliance with regulatory standards and best practices. Their goal is to balance patient care needs with organizational efficiency, ultimately improving patient outcomes and reducing unnecessary expenses.
More about Director Of Utilization Management jobs
What cities are hiring for Director Of Utilization Management jobs? Cities with the most Director Of Utilization Management job openings:
What are the most commonly searched types of Of Utilization Management jobs? The most popular types of Of Utilization Management jobs are:
What states have the most Director Of Utilization Management jobs? States with the most job openings for Director Of Utilization Management jobs include:
Director Of Utilization Management jobs near you
Infographic showing various Director Of Utilization Management job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 83% Full Time, 14% Part Time, 1% Temporary, and 1% Contract. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $52,322 per year, or $25.2 per hour.

RN Manager of Utilization Management

Blaze Health

Robbinsdale, MN • On-site, Remote

$52.46 - $81.30/hr

Other

Medical, Retirement, PTO

Posted 13 days ago

Job description

RN Manager of Utilization ManagementRobbinsdale, MN

Posting Date: Jun 25 2026

Apply now Back to search

Requisition Number: 513885

Why North Memorial Health?

At North Memorial Health, you're part of an inclusive health team that is rooted in our values: Advocate Courageously, Rally Together, Respect Uniqueness and Create Impact. Empathy and care are at the heart of North's culture which is designed to actively support each team member's wellbeing and growth. Our strength lies in our diversity, and we embrace the unique contributions and experiences of each person. Together, we empower patients to achieve their best health.

Our health system encompasses two hospital locations in Robbinsdale and Maple Grove as well as a network of 23 clinics which includes 13 primary clinics, 6 specialty clinics, 4 urgent care/urgency centers and emergency care offerings covering five counties. Our Robbinsdale Hospital, established in 1954, is a 385-bed facility recognized as the top Level 1 Trauma center for 25 years, as well as serving as a Level II pediatric trauma center. Our Maple Grove Hospital was established in 2009, is a 134-bed facility recognized as a top hospital in the state for Women and Children Care, with a Level III NICU, and is the largest Family Birth Center in the state (~5,000 deliveries per year and over 60,000 babies delivered). Both have been named to the 2022 Fortune/Merative 100 Top Hospitals list, 2023 Women's Choice Award Best Hospitals list.

Benefits the North Way!

As North Memorial Health is a non-profit organization you are eligible for the Public Student Loan Forgiveness program. Most part-time and all full-time positions are eligible for benefits.

  • Health & Welfare Benefit Packages
  • 401k Retirement Match or Pension Plan, based on workgroup eligibility 
  • Generous Paid Time Off (PTO) Plans
  • Adoption Reimbursement up to $3000 per child
  • Child Care Discount Program with New Horizon 10% off weekly childcare tuition
  • Education/Tuition Reimbursement 
  • 24/7 Fitness Center Access for all benefit eligible team members

Commitment to Diversity, Equity & Inclusion

At North Memorial Health we recognize that the strength of our team lies in our diversity and make every effort to embrace the unique contributions and experiences of each person on our team. We strive to ensure that everyone feels like they are a valuable part of our community, with initiatives that reinforce our belief in diversity, equity, and inclusivity, to promote a workforce that enables authenticity, as we want to be our best when providing effective services to our patients. We acknowledge and celebrate the unique traditions, backgrounds, languages, beliefs, and customs of our community, and want everyone to feel welcome. Through our DE&I initiatives we hope to dispel myths, assumptions, and acts of implicit bias.

About this position

The Utilization Management Manager helps develop and advance the strategic and tactical utilization review goals of NMH. The Manager manages the NMH System Utilization Management program and staff, including services provided at North Memorial Health Hospital and Maple Grove Hospital. The Utilization Management program includes processes for determining insurance authorization, medical necessity, patient status management and payor denials/appeals for medical necessity.

Requirements

Education

Four-year nursing degree required.   

Experience

Registered Nurse with a minimum of 4 years clinical experience in an acute hospital setting required.
Minimum of 5 years of utilization management experience required.

Familiar with State and Federal standards/requirements.
Knowledgeable about third party payer source criteria for medical necessity.
Organized and able to meet deadlines consistently.
Experienced in team and collaborative approaches to management. Ability to work with various individuals across the organization to facilitate change and build interdepartmental cooperation.
Excellent written and verbal communication skills.  

Licensure/Certification

The North Memorial Health System is dedicated to building a diverse, inclusive, and authentic workplace, so if you're excited about this role, but your past experience doesn't perfectly align with every qualification listed, we encourage you to apply anyway. You may still be the right candidate for this or other roles.

Work Group: Non Contract

Hours per two week pay period: 80

Shift: Days 8 hours    

Weekend Requirement: None

Call Requirement: None

Remote or On-site: Hybrid Remote- Must live in MN or WI 

FLSA Status: Exempt

Benefit Eligibility: Health insurance benefits are available for this position. North Memorial Health offers multiple health plans based on work group eligibility.

Salary Range: L12 ($52.46 - $81.30), based on experience  

Shift Differential: Compensation may include shift differential pay depending on the position and shift worked.

STI Bonus Eligible: True 15%

Employment Sponsorship: Applicants must be currently authorized to work in the United States on a full-time basis. Work visa sponsorship is not available for this position

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EEO/AA STATEMENT

North Memorial Health is an equal employment and affirmative action employer. North Memorial Health does not discriminate against any employee or applicant for employment because of race, color, religion, sex, national origin, age, disability, genetic information, marital status, veteran status, sexual orientation, gender identity, creed, status with respect to public assistance, or other protected class status. North Memorial Health provides reasonable accommodation to disabled applicants and employees and takes affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to protected class status. If you believe that you have been treated in a way that does not conform to these statements, please contact our HR Service Center: JobApplicationAssistance@NorthMemorial.com. If you need a reasonable accommodation, due to a disability, or to assist with the application process, please contact our HR Service Center: JobApplicationAssistance@NorthMemorial.com.


INSPECTION OF AAP
North Memorial Health is a Federal government contractor or subcontractor.
As a part of our obligations under law, we must develop a written Affirmative Action Program for Individuals with Disabilities and Protected Veterans, as specified by law (AAP).
This AAP is available for inspection by applicants and employees in the Human Resources Office during normal business hours.
Link to Policy


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