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Director Utilization Management Jobs in Tennessee

HealthTrust

Value Analysis Director

Murfreesboro, TN · On-site

Drive implementation of system-wide product standardization, utilization management, and clinical ... Direct multiple projects and tasks in a fast-paced environment. * Assimilates information from a ...

HealthTrust

Value Analysis Director

Franklin, TN · On-site

Drive implementation of system-wide product standardization, utilization management, and clinical ... Direct multiple projects and tasks in a fast-paced environment. * Assimilates information from a ...

HealthTrust

Value Analysis Director

Nashville, TN · On-site

Drive implementation of system-wide product standardization, utilization management, and clinical ... Direct multiple projects and tasks in a fast-paced environment. * Assimilates information from a ...

HealthTrust

Value Analysis Director

Lebanon, TN · On-site

Drive implementation of system-wide product standardization, utilization management, and clinical ... Direct multiple projects and tasks in a fast-paced environment. * Assimilates information from a ...

Ardent Health

Laboratory Services Director

Brentwood, TN · On-site

$100K - $131K/yr

The Laboratory Services Director provides strategic leadership and oversight for the organization ... Drives laboratory standardization, utilization management, process improvement, and technology ...

Ardent Health

Laboratory Services Director

Brentwood, TN · On-site

$100K - $131K/yr

The Laboratory Services Director provides strategic leadership and oversight for the organization ... Drives laboratory standardization, utilization management, process improvement, and technology ...

Ardent Health

Laboratory Services Director

Brentwood, TN

$100K - $131K/yr

The Director partners with facility leaders, pathologists, physicians, operations, finance, and ... Drives laboratory standardization, utilization management, process improvement, and technology ...

HiredFirst

Director Case Management

Nashville, TN · On-site

$109K - $135K/yr

A Director of Case Management opportunity is available in Nashville, TN. This leadership role ... utilization across the department. The role. Reporting to senior clinical and financial leadership ...

CivicMinds, Inc.

CMO

Memphis, TN · On-site

Previous experience as Medical Director, Associate CMO, or VP of Medical Affairs preferred * Experience with quality improvement, utilization management, and clinical protocol development Key ...

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Showing results 21-40

All JobsUtilization Management JobsDirector Utilization Management JobsDirector Utilization Management Jobs in Tennessee

Director Utilization Management information

See Tennessee salary details

$16.3K

$47.5K

$76.2K

How much do director utilization management jobs pay per year?

As of Aug 9, 2026, the average yearly pay for director utilization management in Tennessee is $47,488.00, according to ZipRecruiter salary data. Most workers in this role earn between $36,300.00 and $54,500.00 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?

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 Tennessee? The most popular types of Utilization Management jobs in Tennessee are:
What are popular job titles related to Director Utilization Management jobs in Tennessee? For Director Utilization Management jobs in Tennessee, the most frequently searched job titles are:
What job categories do people searching Director Utilization Management jobs in Tennessee look for? The top searched job categories for Director Utilization Management jobs in Tennessee are:
What cities in Tennessee are hiring for Director Utilization Management jobs? Cities in Tennessee with the most Director Utilization Management job openings:
Director Utilization Management jobs near you
Infographic showing various Director Utilization Management job openings in Tennessee as of August 2026, with employment types broken down into 81% Full Time, 16% Part Time, 1% Temporary, and 2% Contract. Highlights an 86% Physical, 4% Hybrid, and 10% Remote job distribution, with an average salary of $47,488 per year, or $22.8 per hour.

Billing Specialist and Utilization Review for Recovery Clients

Samaritan Recovery Community

Nashville, TN • On-site

$18.75 - $25.25/hr

Full-time

Re-posted 7 hours ago

Job description

) Utilization Review and Support Specialist
Classification: Full-time, non-exempt
Minimum Qualifications: Minimum two years of college or associate degree in a human service-related field or LADAC eligible. Minimum two years of experience working in substance abuse treatment admissions/medical records. Demonstrated experience conducting insurance precertification and continued stay reviews, client assessments, and billing.
Job Summary: Responsible for working collaboratively with the Leadership and Agency Departments to conduct precertification and concurrent reviews with insurance organizations, managing insurance billing, compiling monthly reports, completing state billing (TNWITS), and auditing client electronic and paper records. Consistently maintain client and program-related records per agency standards; collect data and prepare statistical reports; Provide support services to clinical and admissions staff as required; and perform other related duties as required.
Duties: Verify client insurance coverage and benefits
Works collaboratively with the various departments utilizing ASAM criteria to complete thorough and timely precertification and continued stay reviews for residential and intensive outpatient programs. Communicate pre-certification and review information to clinical and admissions staff.
Submit insurance billing information to managed care organizations, and monitor payments and denials of payment.
Submit all required documentation to managed care organizations, including PINs, discharge summaries, and release of information forms. As needed, assist the clinical team in scheduling required TnCare discharge appointments.
Attend TnCare and third party payer meetings, keep informed of changes in the insurance industry, and report updates to the Director.
Manage and conduct state billing in TNWITS system. Batch and enter TNWITS encounters weekly. Balance the SRC database to TNWITS monthly, submit invoices to the SRC Administrative Assistant, and submit corrections if needed.
Conduct Level I record audits for per applicable agency policy and procedure.
Interview clients on the telephone for pre-screening and assist admissions in scheduling screening appointments.
Prepare Utilization Management and statistical reports related to all programs for the PSO.
Participate in Professional Staff Organization meetings
The Employer retains the right to change or assign other duties to this position.

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