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Director Utilization Management Jobs in Florida (NOW HIRING)

Memorial Healthcare

The Medical Director of Case Management and Utilization Review leads the hospital specific execution of the Case Management (CM) and Utilization Management (UR) and related activities. The Medical ...

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$13.5K

$39.1K

$62.8K

How much do director utilization management jobs pay per year?

As of May 28, 2026, the average yearly pay for director utilization management in Florida is $39,100.00, according to ZipRecruiter salary data. Most workers in this role earn between $29,900.00 and $44,800.00 per year, depending on experience, location, and employer.

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 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 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.
More about Director Utilization Management jobs
What are the most commonly searched types of Utilization Management jobs in Florida? The most popular types of Utilization Management jobs in Florida are:
What are popular job titles related to Director Utilization Management jobs in Florida? For Director Utilization Management jobs in Florida, the most frequently searched job titles are:
What job categories do people searching Director Utilization Management jobs in Florida look for? The top searched job categories for Director Utilization Management jobs in Florida are:
What cities in Florida are hiring for Director Utilization Management jobs? Cities in Florida with the most Director Utilization Management job openings:
Director Utilization Management jobs near you
Infographic showing various Director Utilization Management job openings in Florida as of May 2026, with employment types broken down into 100% Full Time. Highlights an 93% In-person, and 7% Remote job distribution, with an average salary of $39,100 per year, or $18.8 per hour.
Director of Utilization Management

Director of Utilization Management

PARTNERSHIP FOR STRONG FAMILIES INC

Gainesville, FL • On-site

Full-time

Posted 4 days ago

Job description

The Director of Utilization Management is responsible for overseeing service authorizations and the Certified Behavioral Health Assessment (CBHA) process, ensuring that services for children are producing desired outcomes and are achieving permanency and for managing a team of individuals who serve to make direct connections between the needs of the community's children and families and the providers that meet those needs. This position is also responsible for the continuous quality improvement and data analytics associated with the Utilization Management (UM) units and may serve in other such capacities outside of these units. This position reports directly to the Vice President of Information Technology and Utilization Management.

ESSENTIAL JOB FUNCTIONS

  • Provides direct supervision of professional and administrative positions assigned to the Utilization Management Department.
  • Analyzes and reports Utilization Management data for use in budget analyses, staffing and service allocation considerations, quality improvement, and performance measure analyses.
  • Tracks, manages, and reports on department spending, based on the annually approved departmental budget, which includes collaborating with the Finance Department to review spending and allocations.
  • Assists with developing specifications and system operation, efficiencies, and maintenance for data capturing systems used within the Utilization Management Department.
  • Leads the Quality Improvement process within UM, providing input and observations to management staff and the Quality Operations units regarding behavioral health provider performance.
  • Reviews utilization of behavioral health and supportive services provided in in-home and outpatient settings to ensure the maximization of resources.
  • Provides oversight and support for staff processing and reviewing CBHA materials.
  • Reviews and approves invoices for payment ensuring appropriate use of state, federal, and other funding sources, appropriate coding, and cost allocations are utilized to facilitate maximization of resources.
  • Interacts with community agencies to assist children with returning home or achieving permanency.
  • Oversees and directs training relevant to UM including provider and service array with case management, Department of Child & Families (DCF), and other stakeholders.
  • Knows and understands the processes to be followed in relation to complaints by employees regarding harassment and/or retaliation. Fairly and consistently applies all human resource policies as it relates to subordinate staff.
  • Provides documentation to the Vice President of IT in matters of hiring and discipline but lacks the ability to unilaterally hire and terminate.
  • Displays understanding of, and sensitivity to, service population's cultural and socioeconomic characteristics.
  • Performs other related job duties as assigned.

Education and Experience:

Bachelor's degree in related human services or human behavioral field or equivalent; Master's degree in the like preferred; and four (4) years of relevant experience in child welfare, behavioral health, or related field, to include two (2) years in a supervisory capacity; some experience in a Utilization Management function; or an equivalent combination of education and experience.

Special Qualifications:

Certified as a Child Protection Professional preferred.

Licensed Mental Health Professional preferred.

Possession of a valid, State of Florida driver's license to operate the motor vehicle operated. Requirement exists at the time of hire and as a condition of continued employment.

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