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Director Of Utilization Management Jobs (NOW HIRING)

Onvida Health

Hospitalist job in Yuma AZ

Yuma, AZ

$123.75 - $163.25/hr

Medical Director of Utilization Management / Transfer Center DirectorOnvida Health Yuma, Arizona, United States (On-site) We are excited to share a unique physician leadership opportunity at Onvida ...

SIHO Insurance Services, Inc.

Be Seen First

Utilization Management Nurse

Columbus, IN · On-site

Manager of Utilization Management Brief Description of Duties: This position is reserved for a ... Interaction with the SIHO Medical Director or external Medical Reviewers as needed to ensure proper ...

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 ...

Global Force USA

Utilization Review Nurse

Las Vegas, NV · On-site

Graduation from an accredited school of nursing and five (5) years of acute hospital clinical nursing experience, one (1) year of which was in Utilization Management, Case Management, or 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 ...

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Director Of Utilization Management information

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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.
Utilization Management Coordinator- Fulltime

Utilization Management Coordinator- Fulltime

Houston Behavioral Healthcare Hospital

Houston, TX

Other

Medical, Dental, Vision, Retirement

Posted 18 hours ago

Job description

Houston Behavioral Healthcare Hospital (HBHH) is unique in so many ways. Our facility is located in a serene, picturesque setting within the Spring Branch District of West Houston. We have highly qualified caring staff ready to provide exceptional service.

The team at Houston Behavioral Healthcare Hospital strives to be the leaders in Behavioral Health by delivering quality services to those entrusted in our care. By embarking on a path with our community and ensure Compassion, Acceptance, Respect, Empowerment, and Sincerity with each step we take together.

Houston Behavioral Healthcare Hospital (HBHH) currently has an opening for Fulltime Utilization Management Coordinator.

The Utilization Management Coordinator will report to the Director of Utilization Review and will be responsible to provide quality case management services to all patients and their families, to serve as a member of interdisciplinary team supporting the organization's treatment program and philosophy, and assure the deliverance of quality treatment to patients and their families.

Duties:

  • Assists with collecting information from patients and families that will help to develop treatment and discharge plans.
  • Develops and coordinates an individualized discharge plan for the patient by utilizing treatment team and written chart information to determine the patient's aftercare needs.
  • Coordinates with physician individualized discharge planning for patients.
  • Conducts reviews and other communications and documentation as required by payor standards to obtain necessary certification to maximize reimbursement.
  • Act as the liaison for both internal and external reviewers.
  • Helps to complete aftercare appointments that are within seven (7) days of discharge.
  • Other duties as assigned

Knowledge, Skills and Abilities:

  • Basic understanding of human anatomy, specifically musculoskeletal
  • Proficient use of CPT and ICD-10 codes
  • Excellent computer skills including Excel, Word, and Internet use
  • Excellent organizational skills
  • Plans and prioritizes to meet deadlines
  • Excellent customer service skills; communicates clearly and effectively.
  • Ability to multitask and remain focused while managing a high-volume, time-sensitive workload

Job Types: Fulltime

Schedule: Fulltime

  • Monday-Friday
  • 8am-4pm

Requirements

Bachelors Degree in social work, Psychology or related field, preferred.

1 year experience in a medical related field and/or prior authorization experience preferred.

Experience in a Psychiatric setting.

Knowledge of healthcare service delivery systems, and third party reimbursement.

Knowledgeable of Managed Care Environment.

Reliable and flexible.

Great customer service and team player.

Benefits

401-K Plan

Medical, Dental and Vision

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