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Director Utilization Management Jobs in Utah (NOW HIRING)

Jobtailor

Value Based Care Director

Murray, UT · On-site

$180 - $280/hr

Experience aligning quality, utilization management, care management, and population health programs to value-based performance goals. * Demonstrated experience working directly with providers ...

Imh

Value Based Care Director - Select Health

Murray, UT

$59.50 - $91.84/hr

The Director partners closely with executive leadership, provider organizations, and internal ... Partner with Clinical Operations to align care management, utilization management, and population ...

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Director Utilization Management information

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 Utah?

The most popular types of Utilization Management jobs in Utah are:

What are popular job titles related to Director Utilization Management jobs in Utah?

For Director Utilization Management jobs in Utah, the most frequently searched job titles are:

What job categories do people searching Director Utilization Management jobs in Utah look for?

The top searched job categories for Director Utilization Management jobs in Utah are:

What cities in Utah are hiring for Director Utilization Management jobs?

Cities in Utah with the most Director Utilization Management job openings:

Director Utilization Management jobs near you
Infographic showing various Director Utilization Management job openings in Utah as of August 2026, with employment types broken down into 91% Full Time, and 9% Part Time. Highlights an 73% In-person, and 27% Remote job distribution.

Medical Director - Utilization Management (Remote)

MRIoA

Salt Lake City, UT • On-site, Remote

$240K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 28 days ago

Job description

Description
Who We Are - Motivated by Purpose. Powered by Clinical Expertise.
Founded in 1983, we're a clinically driven, tech-enabled utilization management company offering expert clinical reviews, regulatory guidance, and actionable insights to healthcare organizations.
Excellence starts with our people.
WE OFFER
  • A competitive compensation package
  • Benefits include healthcare, vision, and dental insurance
  • A generous 401(k) match
  • Paid vacation, PTO, and holidays
  • Growth and training opportunities
  • An award-winning remote work environment

Position Summary
Our Medical Director, also known as a Physician Advisor, is responsible for performing clinical utilization management, peer review activities, and clinical quality management activities.
Key Responsibilities
  • Perform utilization management case reviews.
  • Maintain productivity score per company standard.
  • Maintain annual quality score per company standard.
  • Complete annual inter-rater reliability testing.
  • Train across all queues as requested by MRIoA leadership.
  • Complete all client specific training as requested by MRIoA leadership.
  • Maintain up-to-date records of case completion if required
  • Consistently show willingness to take cases as requested.
  • Demonstrate respect in interactions across the company.
  • Consistently submit scheduling requests at least three months in advance. Consistently work scheduled hours.
  • Provide ideas for promotion and growth of the company as requested (i.e., contribute to the vision of the company).
  • Respond appropriately and in a timely manner to licensing/CME requests from the Senior Medical Directors, Vice President of Medical Affairs, or Chief Medical Officer and/or administrative team.
  • Actively participate in the MRIoA evaluation process (both company and individual).
  • Participate in all company meetings and committees as requested.
  • Complete other duties as requested or approved by the CEO and/or chief medical officer.
  • Thorough understanding of the Company's clients, products, departments, workflows, and applicable regulatory requirements and accreditation standards

Work Schedule
  • 40 hours per week
  • Five 8-hour shifts or four 10-hour shifts (available after training)
  • Shifts scheduled between 6:00 AM - 7:00 PM MST
  • Includes 2-3 weekend rotating shifts per month
  • Schedules are fixed and released 60 days in advance

Compensation & Expanded Benefits
  • Base salary: $240,000 per year
  • 20 days of Paid Time Off per year
  • 6 company Holidays (New Year's, Memorial Day, Independence Day, Labor Day, Thanksgiving, Christmas) and 1 Floating Holiday
  • 8 days of Paid Sick Leave
  • Medical and Prescription Benefits administered by Aetna
  • Dental and Vision benefits
  • Basic Life and Accidental Death and Dismemberment (AD&D) Insurance
  • Short-Term & Long-term Disability insurance

Requirements
Skills and Experience
  • Minimum of five years' full-time equivalent experience providing direct clinical care to patients
  • Minimum of five years' experience administering utilization management and peer review programs preferred
  • Credentialed and privileged by the Company's Credentialing Committee
  • Obtain additional state licensure as required for the position

Education:
  • MD/DO degree
  • Current, unrestricted medical license as required for clinical practice in a state of the United States
  • Board certification by a medical specialty board approved by the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA) or other board recognized by URAC preferred

Additionally:
  • Malpractice insurance is not required, as physicians do not provide direct patient care. Reviewers are covered under MRIoA's Errors and Omissions policy.

Work Environment:
Ability to sit at a desk, utilize a computer, telephone, and other basic office equipment is required. This role is designed to be a remote position (work-from-home).
Diversity Statement:
Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
Drug-Free Workplace:
This company is a drug-free workplace. All candidates are required to pass a Background Screen before beginning employment. All newly hired employees will take a Drug Screen, as well as agreeing to all necessary Compliance Regulations on their first day of employment. Employees are required to adhere to all applicable HIPAA regulations and company policies and procedures regarding the confidentiality, privacy, and security of sensitive health information.
California Consumer Privacy Act (CCPA) Information (California Residents Only):
  • Sensitive Personal Info: MRIoA may collect sensitive personal info such as real name, nickname or alias, postal address, telephone number, email address, Social Security number, signature, online identifier, Internet Protocol address, driver's license number, or state identification card number, and passport number.
  • Data Access and Correction: Applicants can access their data and request corrections. For questions and/or requests to edit, delete, or correct data, please email the Medical Review Institute at HR@mrioa.com.

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