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Director Of Utilization Jobs (NOW HIRING)

UHS

Director of Utilization Management

Danville, VA · On-site

$79K - $95K/yr

Responsibilities The Hughes Center is seeking a talented and dynamic Director of Utilization Management to join our team of dedicated healthcare professionals! The Hughes Center is a highly ...

UHS

Director of Utilization Management

Danville, VA

The Director of Utilization Management assists admissions in screening patients at the pre-hospital level to ensure that admission criteria are met, and when admitted, follows the chart checking that ...

UHS

Director of Utilization Management

Danville, VA · On-site

The Director of Utilization Management assists admissions in screening patients at the pre-hospital level to ensure that admission criteria are met, and when admitted, follows the chart checking that ...

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

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 ...

Integra Partners

Director of Utilization Management

Troy, MI · On-site +1

$160K - $160K/yr

KNOWLEDGE/SKILLS/ABILITIES The Director of Utilization Management's responsibilities include but are not limited to: * Prepare and maintain Utilization Review Plan policies and procedures * Obtain or ...

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 ...

Medix

Director of Utilization Management

Pittsburgh, PA · On-site

$150 - $200/hr

Job Summary Our client is seeking a Director of Utilization Management to conduct utilization management reviews and ensure compliance with medical policy criteria. The role involves collaborating ...

Medix

Director of Utilization Management

Manhattan, NY · On-site

$109.15 - $151.44/hr

Job Summary Our client is seeking a skilled Director of Utilization Management to oversee the delivery of utilization management services, including case reviews, peer reviews, and appeals. The ...

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Director Of Utilization information

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$18K

$52.3K

$84K

How much do director of utilization jobs pay per year?

As of Sep 13, 2026, the average yearly pay for director of utilization 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 does a director of utilization do?

A Director of Utilization oversees the utilization management process within healthcare organizations, ensuring that patients receive appropriate, efficient, and cost-effective care. They are responsible for developing and implementing policies to evaluate the necessity, appropriateness, and efficiency of medical services. Their role often includes supervising utilization review staff, analyzing data to improve patient outcomes, and ensuring compliance with healthcare regulations and payer requirements. This position is crucial for balancing quality care with cost control and resource management.

What are the key skills and qualifications needed to thrive as a director of utilization?

To thrive as a Director of Utilization, you need in-depth knowledge of utilization management, healthcare regulations, and clinical review processes, typically supported by an advanced degree in healthcare or nursing and relevant licensure. Familiarity with utilization management software, electronic health records (EHRs), and data analysis tools is essential for overseeing workflow and compliance. Strong leadership, communication, and critical thinking skills help in guiding teams, collaborating with providers, and making complex decisions. These competencies are crucial to ensure efficient resource use, regulatory compliance, and optimal patient care outcomes.

What are some common challenges faced by a director of utilization in managing resource allocation across multiple departments?

A Director of Utilization often encounters the challenge of balancing resource allocation among departments with competing priorities while ensuring compliance with regulations and organizational goals. Coordinating with clinical and administrative teams to optimize patient flow, reduce unnecessary utilization, and monitor key metrics requires strong communication and analytical skills. Additionally, adapting to shifting healthcare policies and payer requirements can add complexity to daily operations. Proactively addressing these challenges through cross-functional collaboration and continuous process improvement is key to success in this role.

What is the difference between Director Of Utilization vs Utilization Manager?

AspectDirector Of UtilizationUtilization Manager
CredentialsBachelor's degree, often with healthcare or related certificationsBachelor's degree, relevant certifications may be preferred
Work EnvironmentStrategic planning, overseeing utilization across departmentsOperational focus, managing daily utilization activities
Industry UsageCommon in healthcare, insurance, and staffing agenciesTypically found in healthcare and staffing industries
Primary FocusSetting policies and strategies for optimal resource useImplementing utilization policies and monitoring compliance

The main difference is that the Director Of Utilization focuses on strategic planning and policy development, while the Utilization Manager handles day-to-day management and implementation of utilization practices. Both roles are essential in optimizing resource use within organizations, especially in healthcare and staffing sectors.

What cities are hiring for Director Of Utilization jobs?

Cities with the most Director Of Utilization job openings:

What states have the most Director Of Utilization jobs?

States with the most job openings for Director Of Utilization jobs include:

What are popular job titles related to Director Of Utilization jobs?

For Director Of Utilization jobs, the most frequently searched job titles are:

Director Of Utilization jobs near you

Director of Utilization Review

Midland, TX

Signet Health Corporation
Health Care and Social Assistance • 51 - 200 employees
Learn more about Signet Health Corporationexternal

Full-time

Re-posted 16 days ago

Key responsibilities

  • Oversee admission, continued-stay, and discharge reviews using clinical criteria such as InterQual or MCG.

  • Manage pre-certifications, concurrent reviews, and peer-to-peer escalations with various payers including commercial insurers, Medicare, and Medicaid.

  • Monitor key metrics like length of stay, denial rates, approval trends, and payer mix to ensure regulatory compliance and operational efficiency.

Job description

Overview

Director of Utilization Review - Permian Basin Behavioral Health Center


Signet Health is currently recruiting for a Director of Utilization Review for a New, free-standing psychiatric hospital located at Permian Basin Behavioral Health Center in Midland, TX.

The Director of Utilization Review is responsible for managing operations to ensure that all behavioral health patients receive the appropriate level of care, and that all services rendered meet medical necessity, payer requirements, Texas Behavioral Health regulations, and DNV accreditation standards.


This is an onsite position. The schedule is Monday – Friday from 8:00 AM – 5:00 PM.


Core Responsibilities

  • Utilization Management: Conduct and oversee admission, continued-stay, and discharge reviews using clinical criteria (InterQual or MCG).
  • Insurance & Payer Relations: Manage pre-certifications, concurrent reviews, and peer-to-peer escalations with commercial insurers, Medicare, and Texas Medicaid managed care.
  • Denial Management: Intervene early on potential denials, lead appeal processes, and coordinate with revenue cycle teams.
  • Regulatory Compliance: Maintain adherence to Texas Health and Human Services (HHS) regulations, DNV/ISO standards, and CMS conditions of participation.
  • Interdisciplinary Collaboration: Work alongside psychiatrists, nursing staff, and social services during daily treatment team meetings to support patient progression and efficient discharge planning.
  • Data Tracking: Monitor key metrics including length of stay (LOS), denial rates, approval trends, and payer mix.

Responsibilities

  • Licensure: Current, unencumbered Registered Nurse (RN) license in the State of Texas (will also accept advanced behavioral health licenses like LCSW or LPC depending on scope).
  • Clinical Experience: Minimum of 2 years of psychiatric or behavioral health clinical nursing experience.
  • UR/Managed Care Background: 2+ years of specific experience in utilization review, case management, or managed care environments (ideally involving Texas Medicare/Medicaid).
  • Technical Knowledge: Proficiency with evidence-based criteria sets such as InterQual, MCG and electronic medical record (EMR) systems.
  • Skills: Strong negotiation, critical thinking, regulatory compliance tracking, and professional communication abilities.

Qualifications

Living in Midland, Texas adds to the appeal, offering a high quality of life with affordable housing, short commutes, excellent schools, and a welcoming community. Midland blends small-city convenience with big-opportunity energy, featuring a vibrant arts scene, outdoor recreation, and easy access to regional travel—making it an ideal place to grow both professionally and personally.

Working at Permian Basin Behavioral Health Center offers the rare opportunity to be part of a brand-new, mission-driven organization that is transforming access to behavioral health care across West Texas and Southeastern New Mexico. Team members play a meaningful role in building programs, shaping culture, and directly impacting lives in a growing region with a strong sense of purpose and collaboration.

Transforming Lives. Restoring Hope.

Permian Basin Behavioral Health Center (PBBHC) is a new, comprehensive mental health center serving the Permian Basin region of West Texas and Southeastern New Mexico. Conveniently located between Midland and Odessa, PBBHC will offer both inpatient and outpatient behavioral health services for individuals of all ages.