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Director Optum Utilization Review Jobs (NOW HIRING)

tmn

Utilization Review Specialist

Akron, OH · On-site

$40K/mo

SUMMARY The Utilization Review Specialist is responsible for proactive planning measures, accurate ... May direct and supervise clerical and administrative staff * Provides feedback on performance ...

tmn

Utilization Review Specialist

Akron, OH · On-site

$40K/mo

SUMMARY The Utilization Review Specialist is responsible for proactive planning measures, accurate ... May direct and supervise clerical and administrative staff * Provides feedback on performance ...

UHS

Utilization Review Coordinator

Scottsdale, AZ · On-site

Responsibilities Utilization Review Coordinator Full Time Via Linda Behavioral Hospital is a ... The Utilization Management Coordinator reports to the Utilization Management Director. UM ...

Umpqua Health

Utilization Review Nurse

Roseburg, OR · Remote

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... Escalate complex cases to Medical Directors and request additional documentation as needed

Umpqua Health

Utilization Review Nurse

Roseburg, OR · On-site +1

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR ... Escalate complex cases to Medical Directors and request additional documentation as needed

Umpqua Health

Utilization Review Nurse

Roseburg, OR · Remote

$85K - $105K/yr

UTILIZATION REVIEW NURSE REMOTE, ability to travel to 3031 NE STEPHENS ST. ROSEBURG, OR 97470, as ... Escalate complex cases to Medical Directors and request additional documentation as needed

UHS

Utilization Review Coordinator

Champaign, IL · On-site

Responsibilities Full-time Utilization Review Coordinator Opening The Pavilion Behavioral Health ... Director, at frank.butcherjr@uhsinc.com or by phone at (217)373-1755. About Universal Health ...

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Director Optum Utilization Review information

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$18K

$52.3K

$84K

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

As of Jun 9, 2026, the average yearly pay for director optum utilization review 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 is the difference between Director Optum Utilization Review vs Utilization Review Manager?

AspectDirector Optum Utilization ReviewUtilization Review Manager
CertificationsTypically requires certifications like CCM or URAC accreditationOften requires similar certifications, may vary by employer
Work EnvironmentWorks within Optum or similar healthcare organizations, overseeing utilization review processesManages utilization review teams, often within healthcare providers or insurance companies
ResponsibilitiesStrategic oversight of utilization review policies, compliance, and team leadershipSupervises daily review operations, staff management, and process improvements

The main difference is that the Director Optum Utilization Review typically holds a higher strategic leadership role within Optum, focusing on policy and compliance, while the Utilization Review Manager manages daily operations and staff. Both roles require similar credentials but differ in scope and level of responsibility.

More about Director Optum Utilization Review jobs
What cities are hiring for Director Optum Utilization Review jobs? Cities with the most Director Optum Utilization Review job openings:
What are the most commonly searched types of Optum Utilization Review jobs? The most popular types of Optum Utilization Review jobs are:
What states have the most Director Optum Utilization Review jobs? States with the most job openings for Director Optum Utilization Review jobs include:
What job categories do people searching Director Optum Utilization Review jobs look for? The top searched job categories for Director Optum Utilization Review jobs are:
Director Optum Utilization Review jobs near you
Infographic showing various Director Optum Utilization Review job openings in the United States as of May 2026, with employment types broken down into 95% Full Time, 4% Part Time, and 1% Temporary. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $52,322 per year, or $25.2 per hour.
Utilization Review Specialist

Utilization Review Specialist

West River Health Services

Hettinger, ND • On-site

Full-time

Posted 4 days ago

Job description

Position Summary:
Under the direct supervision of the HIM manager, the UR specialist monitors the utilization of resources, risk management and quality of care for patients in accordance to established guidelines and criteria for designated setting and status. Collection of clinical information necessary to initiate commercial payer authorization. Obtain and maintain appropriate documentation concerning services in accordance to reimbursement agency guidelines.
Excellence in Practice:
  • Performs preadmission review on admissions when required by insurance companies/agencies to comply with policies and procedures.
  • Works in coordination with discharge planner, monitoring medical necessity for admissions and appropriate level of services.
  • May also need to notify physician and patient of authorization denials.
  • Inputs collected data into computer system for insurance communication.
  • Assists with retrospective review of specified charts as required.
  • Obtains extensions in length of stays from insurance companies if needed.
  • Obtains preauthorization and/or precertification of services.
  • Reviews hospital records daily to determine if utilization resources could be served in a better environment, OBS vs INPT.
  • Ability to interact on an interpersonal basis with providers and other staff within the organization.
Essential Job Requirements:
  • Education: Appropriate education level required in accordance with licensure.
  • Experience: Three years of relevant experience with superior communication and interpersonal skills. Minimum one year healthcare or clinical experience required.
  • License Requirements: Licensed Practical Nurse (LPN) license with State Nursing Board and/or possess multistate licensure privileges or a Registered Health Information Technician (RHIT) required. Additional coding certifications also acceptable such as certified coding specialist (CCS), certified coding specialist physician (CCS-P), certified professional coder (CPC) and certified professional coder – hospital (CPC-H).

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