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Director Utilization Management Jobs in Colorado

Capital Rx

Prior Authorization Systems Pharmacist

Denver, CO · On-site

$60 - $72/hr

Works with Director, Utilization Management on other responsibilities, projects, and initiatives as needed * Responsible for adherence to the Capital Rx Code of Conduct including reporting of ...

Evolent

Field Medical Director, Vascular Surgeon

Denver, CO · On-site

$130 - $140/hr

As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical ...

TriOptus LLC

Director of Claims

Denver, CO · On-site

Director of Claims Management Denver, Colorado (Hybrid) Full-time/Permanent + Benefits ... utilization management. * Perform other special projects as assigned by company management.

Advocate Aurora Health

Case Manager

Aurora, CO · On-site

$20.25 - $26.25/hr

... utilization management (UM) activities.Collaborates with managers, physicians, medical directors, advisory groups, and treatment teams for issues related to physician practices and best practices for ...

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Director Utilization Management information

See Colorado salary details

$18.9K

$55K

$88.3K

How much do director utilization management jobs pay per year?

As of Jul 26, 2026, the average yearly pay for director utilization management in Colorado is $55,017.00, according to ZipRecruiter salary data. Most workers in this role earn between $42,100.00 and $63,100.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in the Director Utilization Management position, and why are they important?

To thrive as a Director Utilization Management, you need a strong background in healthcare administration, case management, and data-driven decision-making, often supported by a clinical degree and several years of management experience. Familiarity with utilization management software, electronic health records (EHRs), and certifications such as CCM or ACM are typically valued. Exceptional leadership, communication, and problem-solving skills distinguish top performers in this role. These competencies are vital for optimizing resource use, ensuring regulatory compliance, and leading teams to meet quality care standards.

What is a Director Utilization Management job?

A Director of Utilization Management oversees the review and approval of medical services to ensure they are necessary, efficient, and cost-effective. They develop strategies to improve care quality while managing healthcare costs, working closely with providers, payers, and regulatory bodies. Their responsibilities include policy development, compliance with healthcare regulations, and leading a team of utilization review professionals. This role is common in hospitals, insurance companies, and managed care organizations.

What are the typical daily responsibilities of a Director Utilization Management?

A Director Utilization Management generally oversees a team responsible for reviewing patient care to ensure appropriate resource use and compliance with payer requirements. Daily tasks may include analyzing utilization data, developing policy and process improvements, collaborating with clinical and administrative staff, and addressing escalated cases or issues. Directors frequently attend strategy meetings, conduct staff training, and engage with external partners like insurance providers. This role requires balancing administrative oversight with hands-on problem solving to support both cost efficiency and quality patient care.

What are the most commonly searched types of Utilization Management jobs in Colorado? The most popular types of Utilization Management jobs in Colorado are:
What are popular job titles related to Director Utilization Management jobs in Colorado? For Director Utilization Management jobs in Colorado, the most frequently searched job titles are:
What job categories do people searching Director Utilization Management jobs in Colorado look for? The top searched job categories for Director Utilization Management jobs in Colorado are:
Director Utilization Management jobs near you
Infographic showing various Director Utilization Management job openings in Colorado as of July 2026, with employment types broken down into 95% Full Time, and 5% Part Time. Highlights an 95% In-person, and 5% Remote job distribution, with an average salary of $55,017 per year, or $26.5 per hour.
Senior Utilization Management Nurse

Senior Utilization Management Nurse

Integrated Resources INC

Denver, CO

Full-time

Medical, Life

Posted 27 days ago

Job description

Company Description

Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.

Job Description

Details:
Under minimal supervision, provides medical and/or behavioral health utilization management for members of Medical Plan in accordance with the schedule of benefits and network criteria defined by the Plan's various lines of business and Center of Medicare & Medicaid Services ("CMS") regulatory requirements. Completes clinical review to determine whether a request can be approved using nationally recognized criteria such as InterQual or MCG, or requires additional review by the Plan's Medical Director.
MINIMUM QUALIFICATIONS:
Education:
Bachelor's degree in Nursing. A combination of education and experience may be substituted for the B.S.N. requirement.
Experience:
Typically, three years of medical utilization management experience working with a health insurance plan, hospital, skilled nursing facility, or surgical center. Managed Care experience is highly preferred.

Qualifications

Responsibilities:
Facility seeks 2 F/T RN Case Managers for excellent contract working in Managed Care department.
Must have BSN, 3 years' experience in medical utilization management, and experience working with a health insurance plan.
Managed Care experience is preferred however hospital experience is also considered.
Seeking highly skilled individual with experience with InterQual and MCG.
Provides medical and/or behavioral health utilization management for members of facility medical plan in accordance with the schedule of benefits and network criteria defined by the Plans various lines of business and Center of Medicare & Medicaid Services.

Additional Information

Regards,

Riya Khem

Life Science Recruiter

Integrated Resources, Inc.

IT Life Sciences Allied Healthcare CRO

(Direct) 732-844-8721 | (W) 732-549-2030 x 311 | (F) 732-549-5549

"INC 5000's FASTEST GROWING, PRIVATELY HELD COMPANIES" (8th Year in a Row)




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About Integrated Resources

Sourced by ZipRecruiter

Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.

Industry

Recruiting and staffing services

Company size

51 - 200 Employees

Headquarters location

Edison, NJ, US

Year founded

1996

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