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Director Of Utilization Review Jobs (NOW HIRING)

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 ...

The Director of Utilization Management is required to meet Foundations standards of customer ... The Director of Utilization Management is also responsible for ensuring that the utilization review ...

Director of Utilization

San Rafael, CA · On-site

$105K - $130K/yr

We are seeking a Director of Utilization Review to lead utilization management processes that support appropriate care delivery, regulatory compliance, and effective use of patient benefits. This ...

Director of Utilization

San Rafael, CA · On-site

$105K - $130K/yr

We are seeking a Director of Utilization Review to lead utilization management processes that support appropriate care delivery, regulatory compliance, and effective use of patient benefits. This ...

Direct and manage the day-to-day operations of the Utilization Review department. Responsibilities ESSENTIAL FUNCTIONS: * Monitor utilization of services and optimize reimbursement for the facility ...

Direct and manage the day-to-day operations of the Utilization Review department. ESSENTIAL FUNCTIONS: * Monitor utilization of services and optimize reimbursement for the facility while maximizing ...

Overview The Medical Director of Utilization Management leads and oversees utilization review, case management, quality improvement, and related policy and practice initiatives within their assigned ...

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Director Of Utilization Review information

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How much do director of utilization review jobs pay per hour?

As of Jun 12, 2026, the average hourly pay for director of utilization review in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

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

Directors of Utilization Review often encounter challenges such as balancing regulatory compliance with operational efficiency, managing diverse teams, and ensuring consistent application of utilization management criteria. Addressing these challenges typically involves staying up to date with changing healthcare regulations, fostering open communication within multidisciplinary teams, and implementing robust training programs. Leveraging data analytics tools can also help streamline review processes and improve decision-making, which supports both patient care quality and organizational goals.

What is a Director of Utilization Review?

A Director of Utilization Review is a healthcare management professional responsible for overseeing the utilization review process in hospitals or healthcare organizations. This role ensures that medical services provided to patients are necessary, appropriate, and efficient, while also complying with regulatory and insurance requirements. The Director supervises a team, manages policies, analyzes data, and collaborates with medical staff to optimize patient care and resource use. They play a key role in balancing quality care with cost-effective practices.

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

AspectDirector Of Utilization ReviewUtilization Review Nurse
CredentialsTypically requires a registered nurse (RN) license, often with management experienceRequires an RN license and clinical experience
Work EnvironmentOversees utilization review teams, manages policies, and collaborates with healthcare providersPerforms clinical reviews, assesses patient records, and makes utilization decisions
Employer & IndustryHospitals, insurance companies, healthcare organizationsHospitals, clinics, insurance companies

The main difference is that the Director Of Utilization Review manages teams and policies, focusing on strategic oversight, while the Utilization Review Nurse conducts clinical assessments and reviews patient cases. Both roles require nursing credentials but differ in scope and responsibilities.

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

To thrive as a Director of Utilization Review, you need strong clinical expertise, analytical skills, and an advanced degree in nursing or a related healthcare field—often with RN licensure and significant case management experience. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of regulatory standards like CMS and Joint Commission are typically required. Leadership, effective communication, and critical thinking are vital soft skills for overseeing teams and collaborating with healthcare providers. These skills and qualifications ensure efficient resource use, regulatory compliance, and optimal patient care outcomes.
More about Director Of Utilization Review jobs
What cities are hiring for Director Of Utilization Review jobs? Cities with the most Director Of Utilization Review job openings:
What states have the most Director Of Utilization Review jobs? States with the most job openings for Director Of Utilization Review jobs include:
Infographic showing various Director Of Utilization Review job openings in the United States as of June 2026, with employment types broken down into 99% Full Time, and 1% Part Time. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.
Director of Utilization Review

Director of Utilization Review

UHS

Gulfport, MS • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 23 days ago


Universal Health Services rating

6.7

Company rating: 6.7 out of 10

Based on 248 frontline employees who took The Breakroom Quiz

526th of 871 rated healthcare providers


Job description

Responsibilities

We are now offering a $5,000 sign-on bonus for our Utilization Review Director opening!

Gulfport Behavioral Health System is an acute behavioral health hospital on the Mississippi Gulf Coast providing inpatient, partial hospitalization and outpatient services to children, adolescents, and adults.  We have served our community for over 30-years and our Patriot Support Program provides inpatient around-the-clock mental health treatment to help military members and their families, veterans, and first responders cope with stressful issues every day.

Visit us online at: https://gulfportbehavioral.com

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 philosophy and objectives of the facility; evaluates patient medical records to determine severity of patient’s illness and determines the appropriateness of level of care; serves as liaison for patients and hospital with insurance companies; negotiates and advocates for patient length of stay and level of care; oversees utilization review activities with other departments to ensure reimbursement for services provided by the hospital. 

Benefit Highlights:

  • Challenging and rewarding work environment
  • Career development opportunities within UHS and its Subsidiaries
  • Competitive Compensation
  • Excellent Medical, Dental, Vision and Prescription Drug Plan
  • 401(K) with company match and discounted stock plan
  • Generous Paid Time Off
  • Free Basic Life Insurance
  • Tuition Reimbursement

If you would like to learn more about this position before applying, please contact Madison Reddell, Clinical Recruiter, at Madison.Reddell@uhsinc.com or by phone at (484)-584-2790.

About Universal Health Services
One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (NYSE: UHS) has built an impressive record of achievement and performance, growing since its inception into a Fortune 500® corporation. Headquartered in King of Prussia, PA, UHS has 101,500 employees. Through its subsidiaries, UHS operates 29 acute care inpatient facilities, 346 behavioral health inpatient facilities and 168 outpatient and other facilities in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom.


Qualifications

Education: Bachelor degree in Nursing or Master’s Degree in human services field preferred.

Experience:  Minimum of 2 years clinical experience and 1 year of management experience with case management and the utilization review process including concurrent reviews. Previous continuum of care experience highly preferred.

Licensure:  Current license in the state of Missisippi, including RN, LMSW, LMFT, LPC

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

Avoid and Report Recruitment Scams

We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information.

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.

Qualifications:

Education: Bachelor degree in Nursing or Master’s Degree in human services field preferred.

Experience:  Minimum of 2 years clinical experience and 1 year of management experience with case management and the utilization review process including concurrent reviews. Previous continuum of care experience highly preferred.

Licensure:  Current license in the state of Missisippi, including RN, LMSW, LMFT, LPC

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

Avoid and Report Recruitment Scams

We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information.

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.

Education:UNAVAILABLEEmployment Type: FULL_TIME

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About Universal Health Services

Sourced by ZipRecruiter

Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

King of Prussia, PA, US