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Director Utilization Management Jobs in Tennessee

HCA Healthcare

Medical Director

Nashville, TN · On-site

Offers input on managed care contracting issues, best demonstrated practices, process ... directors for collaboration and process improvement. Functions as a core team member of the denial ...

New

HCA Healthcare

Medical Director

Franklin, TN · On-site

Offers input on managed care contracting issues, best demonstrated practices, process ... directors for collaboration and process improvement. Functions as a core team member of the denial ...

New

HCA Healthcare

Medical Director

Lebanon, TN · On-site

Offers input on managed care contracting issues, best demonstrated practices, process ... directors for collaboration and process improvement. Functions as a core team member of the denial ...

New

HCA Healthcare

Medical Director

Murfreesboro, TN · On-site

Offers input on managed care contracting issues, best demonstrated practices, process ... directors for collaboration and process improvement. Functions as a core team member of the denial ...

New

RXinsider LTD.

Value Analysis Director

Nashville, TN · On-site

$150 - $200/hr

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

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

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 ...

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

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 ...

Ardent Health

Laboratory Services Director

Brentwood, TN · On-site

$150 - $200/hr

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 ...

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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 Sep 8, 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 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 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 does a director of utilization management do?

A director of utilization management oversees the review and approval of healthcare services to ensure they are medically necessary and cost-effective. They develop policies, manage teams of reviewers, and collaborate with healthcare providers and insurance companies to optimize patient care and resource utilization.

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 1% As Needed, 87% Full Time, 10% Part Time, and 2% Contract. Highlights an 84% Physical, 3% Hybrid, and 13% Remote job distribution, with an average salary of $47,488 per year, or $22.8 per hour.

Medical Director

HCA Healthcare

Nashville, TN • On-site

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 3 days ago

New

HCA Healthcare rating

6.5

Company rating: 6.5 out of 10

Based on 2,311 frontline employees who took The Breakroom Quiz

613th of 898 rated healthcare providers

Job description

This position is incentive eligible.
Introduction

Executives thrive with us! HCA Healthcare is one of the nation’s leading providers of healthcare services, comprising of over 180 hospitals and about 2,000 sites of care in 21 states and the United Kingdom. We are looking for a Medical Director for our Work from Home team where excellence creates excellence.

Benefits

Work from Home, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

  • Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
  • Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
  • Free counseling services and resources for emotional, physical and financial wellbeing
  • 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
  • Employee Stock Purchase Plan with 10% off HCA Healthcare stock
  • Family support through fertility and family building benefits with Progyny and adoption assistance.
  • Referral services for child, elder and pet care, home and auto repair, event planning and more
  • Consumer discounts through Abenity and Consumer Discounts
  • Retirement readiness, rollover assistance services and preferred banking partnerships
  • Education assistance (tuition, student loan, certification support, dependent scholarships)
  • Colleague recognition program
  • Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
  • Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

HCA Healthcare has expanded our influence across the healthcare industry by investing $3.5 billion in capital improvements in recent years. Do you want to be an influencer in healthcare? Apply for our Medical Director role today!

Job Summary and Qualifications

The Medical Director serves as a clinical resource and consultant to hospitals by providing identification, facilitation, and resolution of denials. The Medical Director will be responsible for timely completion of assigned peer to peers and documentation of the outcomes. The Medical Director will also provide physician education regarding accurate determination and documentation of the admission status/level of care and presence of complications or comorbidities.  

What you will do in this role   

  • Conducts peer to peers with health plan counterpart for denied inpatient cases.  

  • Acts as a liaison with payers to facilitate approvals and prevent any denials. Facilitates, mentors, and educates other physicians regarding payer requirements.  

  • Performs data analysis related to utilization review (UR) metrics, works with hospital utilization management committees upon request to develop, implement, and monitor action plans related to denial reduction and authorization of level of care.  

  • Offers input on managed care contracting issues, best demonstrated practices, process improvement and utilization management activities, barriers to achieving goals and objectives of initiatives, and denials prevention initiatives.  

  • Demonstrates leadership, collaboration, and effective communication skills.  

  • Participate in the concurrent and retrospective appeal peer-review process.  

  • Provides oversight to the pre bill denial strategy within the payer process.  

  •  Schedules and manages meetings with payer medical directors for collaboration and process improvement. Functions as a core team member of the denial management team.  

  • Educates physicians about ICD coding guidelines (e.g., co-morbid conditions, outpatient vs. inpatient) and clinical terminology to improve their understanding of severity, acuity, risk of mortality, and DRG assignments on their individual patient records.  

What Qualifications you will need:  

  • Licensed (or eligible for licensure) Physician (MD/DO) in a state in the United States.  

  • Board Certification Required (Internal Medicine and Family Medicine preferred)  

  • Preferred work experience as a a physician advisor.  

  • Minimum of 5 years of experience in clinical practice.  

  • Knowledge of InterQual, Milliman or related evidenced based criteria sets.  

  • Familiar with Joint Commission, State and Federal standards/requirements, and DRG vs Per diem reimbursement models. 

  • Knowledgeable about third party payer source criteria of medical necessity.  

  • Organized and able to meet deadlines consistently.  

  • Computer experience required with skills including but not limited to Microsoft Windows, spreadsheets, and word processing.  

Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities.

HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.


"Bricks and mortar do not make a hospital. People do."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder

If you're looking for a leadership opportunity that provides both personal satisfaction and professional growth, apply to join HCA Healthcare as a Medical Director. Unlock your leadership potential with HCA Healthcare.

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

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